Journal of Pathology and Translational Medicine

Original Article

Interobserver diagnostic reproducibility in advanced-stage endometrial carcinoma: Ho Jin Jung, Soo Yeon Lee, Jin Hwa Hong, Yi Kyeong Chun; J Pathol Transl Med. 2021;55(1):43-52. Published online December 3, 2020; DOI: https://doi.org/10.4132/jptm.2020.10.04

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Background
The accurate pathologic diagnosis and subtyping of high-grade endometrial carcinoma are often problematic, due to its atypical and overlapping histopathological features.
Methods
Three pathologists reviewed 21 surgically resected cases of advancedstage endometrial carcinoma. The primary diagnosis was based only on hematoxylin and eosin stained slides. When a discrepancy arose, a secondary diagnosis was made by additional review of immunohistochemical (IHC) stains. Finally, three pathologists discussed all cases and rendered a consensus diagnosis.
Results
The primary diagnoses were identical in 13/21 cases (62%). The secondary diagnosis based on the addition of IHC results was concordant in four of eight discrepant cases. Among four cases with discrepancies occurring in this step, two cases subsequently reached a consensus diagnosis after a thorough discussion between three reviewers. Next-generation sequencing (NGS) study was performed in two cases in which it was difficult to distinguish between serous carcinoma and endometrioid carcinoma. Based on the sequencing results, a final diagnosis of serous carcinoma was rendered. The overall kappa for concordance between the original and consensus diagnosis was 0.566 (moderate agreement).
Conclusions
We investigated stepwise changes in interobserver diagnostic reproducibility in advanced-stage endometrial carcinoma. We demonstrated the utility of IHC and NGS study results in the histopathological diagnosis of advanced-stage endometrial carcinoma.

Citations

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Accuracy of endometrial sampling in the diagnosis of endometrial cancer: a multicenter retrospective analysis of the JAGO-NOGGO
Zaher Alwafai, Maximilian Heinz Beck, Sepideh Fazeli, Kathleen Gürtler, Christine Kunz, Juliane Singhartinger, Dominika Trojnarska, Dario Zocholl, David Johannes Krankenberg, Jens-Uwe Blohmer, Jalid Sehouli, Klaus Pietzner
BMC Cancer.2024;[Epub] CrossRef
Application of NGS molecular classification in the diagnosis of endometrial carcinoma: A supplement to traditional pathological diagnosis
Qunxian Rao, Jianwei Liao, Yangyang Li, Xin Zhang, Guocai Xu, Changbin Zhu, Shengya Tian, Qiuhong Chen, Hui Zhou, Bingzhong Zhang
Cancer Medicine.2023; 12(5): 5409. CrossRef
Risk Stratification of Endometrial Cancer Patients: FIGO Stage, Biomarkers and Molecular Classification
Jenneke C. Kasius, Johanna M. A. Pijnenborg, Kristina Lindemann, David Forsse, Judith van Zwol, Gunnar B. Kristensen, Camilla Krakstad, Henrica M. J. Werner, Frédéric Amant
Cancers.2021; 13(22): 5848. CrossRef

Review

Neuroendocrine Tumors of the Female Reproductive Tract: A Literature Review: Yi Kyeong Chun; J Pathol Transl Med. 2015;49(6):450-461. Published online October 13, 2015; DOI: https://doi.org/10.4132/jptm.2015.09.20

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Abstract PDF

Neuroendocrine tumors of the female reproductive tract are a heterogeneous group of neoplasms that display various histologic findings and biologic behaviors. In this review, the classification and clinicopathologic characteristics of neuroendocrine tumors of the female reproductive tract are described. Differential diagnoses are discussed, especially for non-neuroendocrine tumors showing high-grade nuclei with neuroendocrine differentiation. This review also discusses recent advances in our pathogenetic understanding of these disorders.

Citations

Citations to this article as recorded by

Neuroendocrine Marker Expression in Primary Non-neuroendocrine Epithelial Tumors of the Ovary: A Study of 551 Cases
Michaela Kendall Bártů, Kristýna Němejcová, Romana Michálková, Quang Hiep Bui, Jana Drozenová, Pavel Fabian, Oluwole Fadare, Jitka Hausnerová, Jan Laco, Radoslav Matěj, Gábor Méhes, Adam Šafanda, Naveena Singh, Petr Škapa, Zuzana Špůrková, Simona Stolnicu
International Journal of Gynecological Pathology.2024; 43(2): 123. CrossRef
Mixed neuroendocrine–non-neuroendocrine neoplasm with mucinous adenocarcinoma and amphicrine carcinoma components in the bile duct: an autopsy case
Toji Murabayashi, Yoshihide Kanno, Takashi Odaira, Shinsuke Koshita, Takahisa Ogawa, Hiroaki Kusunose, Toshitaka Sakai, Keisuke Yonamine, Kazuaki Miyamoto, Fumisato Kozakai, Kazuki Endo, Yutaka Noda, Takashi Sawai, Kei Ito
Clinical Journal of Gastroenterology.2023; 16(2): 310. CrossRef
Coexistence of Papillary Thyroid Carcinoma and Strumal Carcinoid Arising from Struma Ovarii in Pregnant Women: a Case Report and Review
Myungsoo Im, Doohwa Kim, Soree Ryang, Bo Hyun Kim
International Journal of Thyroidology.2023; 16(1): 134. CrossRef
Role of radiotherapy in the management of rare gynaecological cancers
R. Morcet-Delattre, S. Espenel, P. Tas, C. Chargari, A. Escande
Cancer/Radiothérapie.2023; 27(8): 778. CrossRef
Small cell carcinoma of the ovary, pulmonary type: A role for adjuvant radiotherapy after carboplatin and etoposide?
Anase S. Asom, Ricardo R. Lastra, Yasmin Hasan, Lori Weinberg, Gini F. Fleming, Katherine C. Kurnit
Gynecologic Oncology Reports.2022; 39: 100925. CrossRef
Neuroendocrine carcinoma of ovary: Hitherto rare entity in primary ovarian tumors
MdA Osama, Seema Rao, Punita Bhardwaj, Geeta Mediratta, Sunita Bhalla, Sonia Badwal
Indian Journal of Pathology and Microbiology.2022;[Epub] CrossRef
MicroRNA and Metabolic Profiling of a Primary Ovarian Neuroendocrine Carcinoma Pulmonary-Type Reveals a High Degree of Similarity with Small Cell Lung Cancer
Stefano Miglietta, Giulia Girolimetti, Lorena Marchio, Manuela Sollazzo, Noemi Laprovitera, Sara Coluccelli, Dario De Biase, Antonio De Leo, Donatella Santini, Ivana Kurelac, Luisa Iommarini, Anna Ghelli, Davide Campana, Manuela Ferracin, Anna Myriam Perr
Non-Coding RNA.2022; 8(5): 64. CrossRef
Neuroendocrine Carcinomas of the Uterine Cervix, Endometrium, and Ovary Show Higher Tendencies for Bone, Brain, and Liver Organotrophic Metastases
Hyung Kyu Park
Current Oncology.2022; 29(10): 7461. CrossRef
Uterine carcinoma admixed with neuroendocrine carcinoma
Maria Victoria Olinca, Anca Potecă, Elvira Brătilă, Mihai Mitran
Ginecologia.ro.2022; 4(38): 32. CrossRef
The puzzle of gynecologic neuroendocrine carcinomas: State of the art and future directions
Giuseppe Caruso, Carolina Maria Sassu, Federica Tomao, Violante Di Donato, Giorgia Perniola, Margherita Fischetti, Pierluigi Benedetti Panici, Innocenza Palaia
Critical Reviews in Oncology/Hematology.2021; 162: 103344. CrossRef
Pitfalls and challenges in managing neuroendocrine carcinoma of gynecological origin: A case series and brief review
Lauren E. Farmer, Rutmi U. Goradia, Nisha A. Lakhi
Clinical Case Reports.2021;[Epub] CrossRef
Primary mixed large cell neuroendocrine and high grade serous carcinoma of the endometrium
Liesel Elisabeth Hardy, Zia Chaudry, King Wan, Chloe Ayres
BMJ Case Reports.2020; 13(9): e234977. CrossRef
Neuroendocrine carcinoma of the endometrium: Disease course, treatment, and outcomes
Kathryn Schlechtweg, Ling Chen, Caryn M. St. Clair, Ana I. Tergas, Fady Khoury-Collado, June Y. Hou, Alexander Melamed, Alfred I. Neugut, Dawn L. Hershman, Jason D. Wright
Gynecologic Oncology.2019; 155(2): 254. CrossRef
Peritoneal Fluid Cytology of Disseminated Large Cell Neuroendocrine Carcinoma Combined with Endometrioid Adenocarcinoma of the Endometrium
Yong-Moon Lee, Min-Kyung Yeo, Song-Yi Choi, Kyung-Hee Kim, Kwang-Sun Suh
Journal of Pathology and Translational Medicine.2019; 53(6): 407. CrossRef
Pro-Gastrin Releasing Peptide: A New Serum Marker for Endometrioid Adenocarcinoma
Mine Kiseli, Gamze Sinem Caglar, Asli Yarci Gursoy, Tolga Tasci, Tuba Candar, Egemen Akincioglu, Emre Goksan Pabuccu, Nurettin Boran, Gokhan Tulunay, Haldun Umudum
Gynecologic and Obstetric Investigation.2018; 83(6): 540. CrossRef
Tumeur neuroendocrine à petite cellule de l’endomètre : prise en charge originale
E. Galmiche, N. Hudry, P. Sagot, P. Ginod, S. Douvier
Gynécologie Obstétrique Fertilité & Sénologie .2017; 45(6): 381. CrossRef
Twist on a classic: vitamin D and hypercalcaemia of malignancy
Juan C Osorio, Masha G Jones, Nina Schatz-Siemers, Stephanie J Tang
BMJ Case Reports.2017; : bcr-2017-220819. CrossRef
Mixed Neuroendocrine-Nonneuroendocrine Neoplasms (MiNENs): Unifying the Concept of a Heterogeneous Group of Neoplasms
Stefano La Rosa, Fausto Sessa, Silvia Uccella
Endocrine Pathology.2016; 27(4): 284. CrossRef
Neuroendocrine tumours in rare sites: differences in nomenclature and diagnostics—a rare and ubiquitous histotype
Elia Guadagno, Gaetano De Rosa, Marialaura Del Basso De Caro
Journal of Clinical Pathology.2016; 69(7): 563. CrossRef
Primary ovarian neuroendocrine tumor arising in association with a mature cystic teratoma: A case report
Nicolas M. Orsi, Mini Menon
Gynecologic Oncology Reports.2016; 17: 83. CrossRef
Benign Endometrial Polyp and Primary Endometrial Small Cell Neuroendocrine Carcinoma Confined to the Polyp: A Rare Association
Pembe Oltulu, Ceyhan Uğurluoğlu, Ayşenur Uğur, Sıdıka Fındık, Lema Tavlı
Journal of Clinical and Experimental Investigations.2016;[Epub] CrossRef

Case Reports

Bilateral Frontal Polymicrogyria: An Autopsy Case Report.: Yi Kyeong Chun, Jong Sun Choi, Je G Chi; Korean J Pathol. 2011;45:S62-S65.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.S1.S62

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Abstract PDF: Bilateral frontal polymicrogyria is a recently recognized syndrome characterized by symmetric polymicrogyria of both frontal lobes that presents with delayed motor and language development, spastic quadriparesis, and variable mental retardation. However, the postmortem findings of this syndrome are not fully elaborated. Here we describe an autopsy case of bilateral frontal polymicrogyria in a male fetus delivered at 22 weeks gestation due to extensive chorioamnionitis. The microscopic findings included a thinned cortical plate with fair neuronal maturation. There were no signs of neuronal damage and the white matter was unremarkable.

Liquid-Based Pap Smear Findings of Uterine Cervical Lymphoma: Three Cases Report.: Jiyoung Kim, Hyesun Kim, Sung Ran Hong, Yi Kyeong Chun, Hy Sook Kim; Korean J Pathol. 2011;45(4):437-440.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.437

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Abstract PDF: Malignant lymphoma of the uterine cervix is rarely diagnosed by cytology because it presents as a subepithelial mass. We report three cases of diffuse large B-cell lymphoma in the uterine cervix with a description of liquid-based pap smear (LBP) findings. All patients were presented with cervical masses, but a suspicion of malignant lymphoma was made in only one case by preoperative LBP. The LBP of two cases showed several atypical lymphoid cells in a clear background. The other case revealed numerous atypical lymphoid cells in a necrotic background. Most tumor cells had an increased N/C ratio, round but focally irregular nuclei, coarse chromatin, and prominent nucleoli. Nuclear blebing, dimpling, and multi-lobulation were also found. Diagnosis of malignant lymphoma by LBP is usually more difficult than by conventional techniques, because of a sparse numbers of cells and the lack of necrotic background. However, well preserved morphological features and a better resolution of nuclear details could be the benefits of LBP.

Original Articles

Evaluation of Low-Grade Squamous Intraepithelial Lesions, Cannot Exclude High-Grade Squamous Intraepithelial Lesions on Cervical Smear.: Sung Ran Hong, Bock Man Kim, Hye Sun Kim, Yi Kyeong Chun, Hy Sook Kim; Korean J Pathol. 2010;44(5):528-535.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.5.528

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Abstract PDF

BACKGROUND
We examined cervicovaginal smears that contained definite low-grade squamous intraepithelial lesion (LSIL) cells and rare atypical cells suggestive of high-grade SIL (HSIL) (ASC-H) or contained borderline dysplastic cells between LSIL and HSIL. Such lesions were classified as LSIL-H. This study aimed to investigate the cytologic and histologic characteristics of LSIL-H category and we evaluated the associated clinical risk.
METHODS
The histologic outcomes of LSIL-H were compared with those of LSIL and ASC-H. Both the cytologic and histologic findings of LSIL-H that were confirmed as cervical intraepithelial neoplasia 2 (CIN2) or greater (CIN2+) were investigated.
RESULTS
LSIL-H accounted for 0.09% of the Pap tests. On the follow-up histology, the most frequent outcome was CIN2, and the risk of CIN2+ was higher than that for ASC-H. In the cases of LSIL-H that was histologically confirmed as CIN2+, most of the atypical cells suggestive of HSIL were cytologically similar to those of CIN2, and the corresponding cervical tissues were characterized by small CIN2+ lesions in a large background of flat condyloma/CIN1. The LSIL-H cases not confirmed on initial colposcopically-directed biopsy required further follow-up.
CONCLUSIONS
LSIL-H may be a valid diagnostic category with distinctive features that are different from LSIL or ASC-H. LSIL-H needs further follow-up for the proper management.

Citations

Citations to this article as recorded by

The Clinical Significance of “Squamous Intraepithelial Lesion of Indeterminate Grade” as a Distinct Cytologic Category
Dorothy Wong, Crystal Teschendorf, Grace Y. Lin, Farnaz Hasteh
American Journal of Clinical Pathology.2012; 137(5): 753. CrossRef

Availability of Immunohistochemistry in the Diagnosis of Follicular Variant of Papillary Thyroid Carcinoma.: Ji Yun Jeong, Jung Sik Jang, Yoon Kyung Sohn, Jin Hyang Jung, Yi Kyeong Chun, Ji Young Park; Korean J Pathol. 2010;44(1):48-55.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.1.48

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Abstract PDF

BACKGROUND
Making the diagnosis of the follicular variant of papillary thyroid carcinoma (FVPTC) is often difficult, and there are no accurate immunohistochemical or molecular markers. The purpose of this study is to evaluate performing immunohistochemistry to make the diagnosis of FVPTC.
METHODS
A total of 249 thyroid lesions were studied. We made the tissue microarray, and we assessed the expression of HBME-1, galectin-3, CD56, and p63.
RESULTS
Galectin-3, HBME-1, and p63 were positive in 79.7%, 79.7%, and 15.9% of the FVPTC, respectively. These immunohistochemical features of FVPTC were between those of classic papillary thyroid carcinoma (CPTC) and those of non-PTC. The CD56 expression was positive in 75.4% of the FVPTC, which is much higher than that of the CPTC (28.3%), and even higher than that of the non-PTC lesions (60%). Comparing FVPTC with CPTC, the expression of galectin-3 was significantly higher and the expression of CD56 was significantly lower in the CPTCs. Comparing the FVPTC with follicular carcinoma (FC), the expression of all the markers was significantly higher in the FVPTC. Comparing PTC with FC, the expression of CD56 was lower and the expressions of the other markers were higher in the PTCs.
CONCLUSIONS
Galectin-3, HBME-1, and p63 can help make the diagnosis of FVPTC, and a cocktail of these markers can be even more useful. But CD56 is not thought to be useful to make the diagnosis of FVPTC.

Citations

Citations to this article as recorded by

A Case of Multifocal Papillary Thyroid Carcinoma Consisting of One Encapsulated Follicular Variant withBRAFK601E Mutation and Three Conventional Types withBRAFV600E Mutation
Wook Youn Kim, Young Sin Ko, Tae Sook Hwang, Hye Seung Han, So Dug Lim, Wan Seop Kim, Seo Young Oh
Korean Journal of Pathology.2013; 47(3): 293. CrossRef

Histologic Correlation of Atypical Glandular Cells in Cervical Smears.: Yi Kyeong Chun, Sung Ran Hong, Hye Sun Kim, Ji Young Kim, Hy Sook Kim; Korean J Pathol. 2009;43(5):453-457.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.5.453

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Abstract PDF

BACKGROUND
The study evaluated the histologic correlation and clinical significance of atypical glandular cells (AGC) detected either on conventional smears (CS) or liquid-based cytology (LBC).
METHODS
Two hundred and seventy-seven (0.11%) of 261,925 cervical smears were interpreted as AGC by the Bethesda system 2001 from January 2006 to December 2008. Cytohistological correlation was performed on 192 cases.
RESULTS
The prevalence of AGC was 0.07% and 0.13% for CS and LBC smears, respectively. Distribution of AGC subcategories were as follows: atypical endometrial cells 53.8%, atypical endocervical cells 22.7%, atypical glandular cells 19.5%, atypical endocervical cells favoring neoplasia 2.2%, and atypical glandular cells favoring neoplasia 1.8%. Fifty-nine (27.4%) of 192 patients were confirmed as having clinically significant lesions comprising endometrial adenocarcinoma (12.5%), endometrial hyperplasia (6.0%), cervical adenocarcinoma (2.3%), high-grade squamous intraepithelial lesion (HSIL) (1.9%), low-grade SIL (1.9%), adenocarcinoma in situ (1.4%), or ovarian metastasis (1.4%).
Conclusion
Compared with CS, LBC was presently associated with a higher prevalence of AGC. Histologic follow-up showed a very low HSIL rate compared to other studies. Endometrial adenocarcinoma was the most common malignant lesion detected because of increasing prevalence of endometrial adenocarcinoma, concentration on endometrial cytology, and introduction of LBC.

Citations

Citations to this article as recorded by

4 Cases of Traditional Korean Medicine Treatment for Patients with Surgical Margin Positive after LEEP in Cervical Intraepithelial Neoplasia
Eun Lee, Kyung-yeob Lee, Byung-kook Yu
Journal of Physiology & Pathology in Korean Medicine.2020; 34(3): 149. CrossRef
Histologic Correlation and Clinical Significance of Atypical Glandular Cells on Cervical Pap Tests: Analysis of 540 Cases at a Single Institution
Tae-Kyu Jang, Jeong-Yeol Park, Dae-Yeon Kim, Dae-Shik Suh, Jong-Hyeok Kim, Yong-Man Kim, Young-Tak Kim, Joo-Hyun Nam
Cancer Investigation.2019; 37(1): 8. CrossRef
Clinicopathological significance of atypical glandular cells on cervicovaginal Pap smears
Mi‐Kyung Kim, Yoo Kyung Lee, Sung Ran Hong, Kyung Taek Lim
Diagnostic Cytopathology.2017; 45(10): 867. CrossRef

Case Reports

Cytology of Synovial Fluid in Gouty Arthritis: Two Cases Report.: Ji Young Kim, Yi Kyeong Chun, Hoi Sook Jang, Bok Man Kim, Hy Sook Kim, Jae Yong An, Sung Ran Hong; Korean J Pathol. 2009;43(1):92-97.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.1.92

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Abstract PDF

Synovial fluid (SF) aspiration cytology is a useful diagnostic tool. For patients with gouty arthritis, the diagnosis is confirmed by the presence of monosodium uric acid (MSU) crystals in the SF, and these crystals are long, pointed ended and needle-shaped and they show strongly negative birefringence. Sometimes, it is difficult to diagnosis between gouty arthritis and other type of inflammatory arthritis. We experienced two unusual cases of gouty arthritis that we performed SF analysis for. The first patient was a 35 year old male who presented with relatively typical clinical symptoms with hyperuricemia, but the SF showed acute inflammatory cells without crystals on light microscopy. Only a few suspected crystals of MSU were identified on polarizing microscopy. The second patient was a 45 year old male who presented with atypical symptoms and pain and swelling of the left ankle and knee joint for 3 weeks. The uric acid level in the serum and urine was increased, but not over the normal limit. However, on light and polarizing microscopy, there were numerous MSU crystals in the SF. Conclusively, in some cases of gouty arthritis, the crystals are not identified on light microscopy or the uric acid level is not dramatically increased. So, the polarizing microscopy, the clinical information and the laboratory findings are all included in the work-up when evaluating the SF cytology of arthritis patients.

Citations

Citations to this article as recorded by

Diagnostic indications of knee joint fluid – current state ofknowledge
Damian Turzański
Diagnostyka Laboratoryjna.2023; 59(4): 1. CrossRef

Cytologic Findings of Malakoplakia of the Uterine Cervix and the Vagina: A Case Report.: Yi Kyeong Chun, Sung Ran Hong, Hye Sun Kim, Ji Young Kim, Bok Man Kim, Hy Sook Kim; Korean J Cytopathol. 2008;19(2):164-167.; DOI: https://doi.org/10.3338/kjc.2008.19.2.164

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Abstract PDF: Malakoplakia is an uncommon chronic granulomatous inflammation that usually involves the urinary and gastrointestinal tracts, but rarely affects the female genital tract. We experienced a case of malakoplakia in a cervicovaginal smear in a 54-year-old woman. Colposcopic examination showed a friable, easily bleeding tissue in the uterine cervix and the vaginal fornix. The cervicovaginal smear consisted of numerous isolated histiocytes, polymorphonuclear leukocytes, lymphocytes, and plasma cells. The histiocytes had an abundant, granular, and degenerated cytoplasm with inflammatory cell debris. Michaelis-Gutmann bodies were readily identified.

Prolapse of Fallopian Tube into Vaginal Vault after Hysterectomy: A case report.: Yi Kyeong Chun, Hy Sook Kim; Korean J Pathol. 1998;32(6):474-475.

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Abstract: The prolapse of a fallopian tube into the vagina is a rare complication of hysterectomy. We recently experienced a case of tubal prolapse after a laparoscopic hysterectomy in a 44-year-old woman. The vaginal examination showed a polypoid mass in the vaginal apex. Microscopically, the mass had the typical appearance of a fallopian tube with chronic inflammation. The cytologic finding of a vaginal vault smear was also described.

Well-Differentiated Papillary Mesothelioma of the Peritoneum: A case report .: Yi Kyeong Chun, Yee Jeong Kim, Sung Ran Hong; Korean J Pathol. 1998;32(9):697-699.

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Abstract: Well-differentiated papillary mesothelioma (WDPM) of the peritoneum is considered to be a distinct subtype of peritoneal mesothelioma and has mostly behaved in a benign fashion. We report a case of WDPM in a 48-year-old-woman. It was incidentally found during a hysterectomy for a uterine cervical carcinoma. Grossly, the tumor was composed of multiple peritoneal nodules, measuring up to 2 cm. Microscopically, the nodules showed well-developed papillae lined by a single layer of cuboidal mesothelial cells. Immunohistochemical staining revealed a positive reaction for cytokeratin and a negative reacion for carcinoembryonic antigen and Leu-M1. Ultrastructurally, the tumor cells showed numerous long, slender microvilli and desmosomes.

Original Articles

Osteochondrodysplasia Pathologic study of 29 autopsy cases.: Yi Kyeong Chun, Yee Jeong Kim, Sung Ran Hong, Min Suk Kim, Je G Chi; Korean J Pathol. 1999;33(1):32-41.

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Abstract PDF: Osteochondrodysplasia is a heterogeneous group of disorders appearing short limbed dwarfism. Because many of these entities are lethal and hereditary, an accurate diagnosis is mandatory. The purpose of this study is to define the clinicopathologic features and radiologic findings of osteochondrodysplasia. We reviewed 29 autopsy cases of congenital short limbed dwarfism, consisting of thanatophoric dysplasia (TD) (12 cases), osteogenesis imperfecta (OI) (12 cases), asphyxiating thoracic dysplasia (ATD) (3 cases), short-rib-polydactyly syndrome (SRPS) (1 case) and hypochondrogenesis (1 case). The gestational age ranged from 16 to 41 weeks. Of 6 fetuses that were born alive, 3 were ATD, 2 were TD and 1 was hypochondrogenesis. TD was frequently complicated by hydramnios. Of 8 cases studied chromosomally, only 1 showed chromosomal abnormality -46XY, inv 9. Intrauterine growth retardation was frequently associated with OI. Pulmonary hypoplasia was present in 23 cases (79%), including all cases of ATD, SRPS and hypochondrogenesis, 11 in TD and 7 in OI. Other associated anomalies were present in 17 cases (59%).

Pseudoangiomatous Stromal Hyperplasia of the Breast A clinicopathological study of 8 cases.: Hye Sun Kim, Yi Kyeong Chun, Yee Jung Kim, Sung Ran Hong, Hy Sook Kim; Korean J Pathol. 1999;33(3):193-198.

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Abstract PDF: Pseudoangiomatous stromal hyperplasia (PASH) of the breast occurs in premenopausal women and is characterized by anastomosing channels lined by spindle cells. It has been suggested to be of hormonal origin. This unusual condition may also be mistaken for a vascular tumor. We analyzed eight cases of PASH of the breast in Samsung Cheil Hospital from 1992 through 1998. All patients were premenopausal and had painless breast lump. Clinical diagnoses were fibroadenomas. Grossly, the masses were well circumscribed, nonhemorrhagic and measure 2.2 to 5 cm. Histologically, they consisted of complex interanastomosing channels lined by slender spindle cells, which resembled low grade angiosarcoma. Cells that line the interanastomosing channels showed no immunoreactivity for Factor VIII and electron microscopic findings consistent with fibroblast. All patients were treated with surgical excision and none of them had recurrence for 1 to 69 months (mean: 19 months) postoperatively. Pathologic diagnosis of PASH may be difficult unless the pathologists are aware of the presence of a mass lesion and appreciate the characteristic stromal changes. PASH should be included in the differential diagnosis of a circumscribed mass, especially in the premenopausal women.

Ductal Carcinoma In Situ of the Breast: Comparison of Histologic Classifications and Correlation with Histologic Grade of Coexisting Invasive Ductal Carcinoma.: Sung Ran Hong, Yee Jeong Kim, Yi Kyeong Chun, Hye Sun Kim, Hy Sook Kim; Korean J Pathol. 1999;33(6):434-442.

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Abstract PDF: Recently developed new classifications (Holland, Van Nuys, modified Lagios) of ductal carcinoma in situ (DCIS) linked to outcome have emphasized the importance of nuclear morphology rather than architecture. We have evaluated these three classifications in ductal carcinomas composed of in situ and invasive carcinomas. The reproducibility of three classifications was assessed (n=49), and the histological grade of the DCIS was compared with the histologic differentiation (modified Bloom & Richardson method) and nuclear grade (modified Black method) of the coexisting invasive ductal carcinoma (n=45). According to Holland classification, the DCIS component was poorly differentiated in 51.0%, intermediately differentiated in 40.8%, and well differentiated in 8.2%. Using the Van Nuys classification, the DCIS component was group 3 (high grade with or without necrosis) in 44.9%, group 2 (non-high grade with necrosis) in 28.6%, and group 1 (non-high grade without necrosis) in 26.5%. According to the modified Lagios classification, the DCIS component was high-grade in 42.8%, intermediate-grade in 32.7%, and low-grade in 24.5%. The histologic grades of the three classifications revealed significant correlations between Holland and Van Nuys classification (p<0.0001) and between Holland and modified Lagios classification (p<0.0001), especially in poorly differentiated/group 3/high-grade DCIS. The reproducibility of classification of the DCIS was 71.4% in the Holland, 61.2% in the Van Nuys, and 55.1% in the modified Lagios classifications. The grade of the DCIS showed significant correlation with the grade of coexisting invasive ductal carcinoma (p<0.0001), especially in poorly differentiated/group 3/high-grade DCIS. In conclusion, DCIS grade, determined by the Holland, Van Nuys or modified Lagios classifications, is closely correlated with the histologic grade of the invasive ductal component in tumors composed of in situ and invasive ductal carcinoma, and may be a useful factor to estimate clinical behavior of DCIS. In our experience the Holland classification is recommended for DCIS classification due to its high reproducibility.

Expression of p53 Protein and Ki-67 in Atypical Ductal Hyperplasia, Ductal Carcinoma in Situ, and Microinvasive Ductal Carcinoma of the Breast.: Yi Kyeong Chun, Hye Sun Kim, Yee Jeong Kim, Sung Ran Hong, Hy Sook Kim, Byung Jun Park, Sung Su Kang, Ji Hyun Lee, Sung Kong Lee, Sun Hee Sung, Woon Sup Han; Korean J Pathol. 2000;34(9):665-672.

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Abstract PDF: Mutation of the p53 gene is one of the most common genetic alterations in invasive breast carcinoma. However, it is unclear that the mutation usually occurs in noninvasive breast lesions. It might be expected that there is a correlation between histologic progression of breast lesions and proliferative rate. We investigated the expression of p53 protein and Ki-67 labelling index (LI) using immunohistochemistry in 16 ductal carcinoma in situ with microinvasion (DCIS-Mi), 56 DCIS, 15 atypical ductal hyperplasia (ADH), and 7 intraductal hyperplasia (IDH). Expression of p53 protein was detected in 33.9% of DCIS and 56.3% of DCIS-Mi and was confined exclusively in Van Nuys DCIS group 2 and 3. In ADH and IDH, no expression of p53 protein was found. There was no significant correlation between Van Nuys DCIS groups and Ki-67 LI. In conclusion, p53 mutation may be involved in the neoplastic progression from ADH to DCIS and is directly related to high nuclear grade and associated necrosis of DCIS.

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