Journal of Pathology and Translational Medicine

Original Article

A Proposal for Creating a Guideline for Cancer Registration of the Fibromatosis, PEComa Group, Malignant Lymphoma In Situ and Dendritic Cell Tumors (III): Changyoung Yoo, Chang Suk Kang, Yoon La Choi, Hye Yoon Kang, Jin Man Kim, Young Hye Koh, Joo Hee Lee, Seung Sook Lee, In Sun Kim, Dong Hoon Kim, Yong Ku Park, Jin Hee Sohn; Korean J Pathol. 2012;46(5):436-442. Published online October 25, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.5.436

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Abstract PDF: Background
Understanding the biologic behavior of a tumor is a prerequisite for tumor registration code assignment. The aim of this report was to propose appropriate behavior codes of the International Classification of Disease Oncology 3 (ICD-O3) to rare, yet pathologically interesting hematopoietic and soft tissue tumors.
Methods
The Study Group for Hematopathology, the Bone and Soft Tissue Pathology Study Group, and the Cancer Registration Committee prepared the questionnaire containing provisional behavior codes of selected diseases.
Results
In situ lesions of mantle cell and follicular lymphomas, dendritic cell tumors, and neoplasms with perivascular epithelioid cell differentiation (PEComa), not otherwise specified were classified as malignant (-/3). The fibromatosis group, with the exception of lipofibromatosis, was proposed as benign (-/0). Lipofibromatosis and several diseases that belong to the PEComa group were proposed as uncertain malignant potential (-/1). For the hematologic and soft tissue tumors, 274 and 288 members of the Korean Society of Pathologists, respectively, provided opinions through questionnaire, and most responders showed agreement with the provisional behavior code proposed.
Conclusions
The determination of behavior codes for the rare diseases described in this study, especially those of the PEComa group or malignant lymphoma, could be viewed as impractical and premature, but this study provides the basis for future research on this topic.

Case Report

Diffuse Large B-Cell Lymphoma Associated with Chronic Inflammation Manifested as a Soft Tissue Mass: Incidental Discovery on Histological Examination.: Sang Yun Ha, Yoon La Choi, Sung Joo Kim, Young Hye Ko; Korean J Pathol. 2011;45(4):417-422.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.417

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We report an extraordinary case of diffuse large B-cell lymphoma arising in a cystic necrotic mass in a 35-year-old man who presented with a soft tissue mass at the site of previous surgery. A benign mass was surgically removed 17 years ago, after which a cystic lesion gradually developed at the same site. The resected mass appeared as a thick-walled cyst filled with brown necrotic and hemorrhagic material. On microscopic examination, the cyst wall was primarily necrotic tissue with some aggregates of large atypical lymphoid cells. These atypical cells were diffusely positive for CD20 and showed a high proliferation index, Epstein-Barr virus positivity, and clonal rearrangement of the immunoglobulin gene. His present condition was diagnosed as Epstein-Barr virus-associated diffuse large B-cell lymphoma arising from chronic inflammation. It is important to be aware of the clinical manifestations and histological features of this rare disease in light of diagnosis and treatment.

Citations

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EBV-negative Fibrin-Associated Large B-Cell Lymphoma Arising in Thyroid Hyperplastic Nodule: Report of a Case and Literature Review
Tin Wai Ho, Wah Cheuk, John K.C. Chan
International Journal of Surgical Pathology.2023; 31(7): 1420. CrossRef
Diffuse Large B Cell Lymphoma in a Prosthetic Aortic Graft
David Bell, David Marshman
Heart, Lung and Circulation.2017; 26(2): e4. CrossRef
Fibrin-associated EBV-positive Large B-Cell Lymphoma
Daniel F. Boyer, Penelope A. McKelvie, Laurence de Leval, Kerstin L. Edlefsen, Young-Hyeh Ko, Zachary A. Aberman, Alexandra E. Kovach, Aneal Masih, Ha T. Nishino, Lawrence M. Weiss, Alan K. Meeker, Valentina Nardi, Maryknoll Palisoc, Lina Shao, Stefania P
American Journal of Surgical Pathology.2017; 41(3): 299. CrossRef
Malignant Lymphoma Mimicking an Infection After Shoulder Surgery
Jabari Ian Justin Martin, Jasmine Bauknight, Vincent Desiderio, Bahman Sadr
Journal of the American Academy of Orthopaedic Surgeons.2017; 25(4): 314. CrossRef
Current Concepts in Primary Effusion Lymphoma and Other Effusion-Based Lymphomas
Yoonjung Kim, Chan Jeong Park, Jin Roh, Jooryung Huh
Korean Journal of Pathology.2014; 48(2): 81. CrossRef

Original Articles

Mucoepidermoid Carcinoma of Tracheobronchial Tree: Clinicopathological Study of 31 Cases.: Sang Yun Ha, Joungho Han, Jae Jun Lee, Young Eun Kim, Yoon La Choi, Hong Kwan Kim; Korean J Pathol. 2011;45(2):175-181.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.2.175

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Abstract PDF

BACKGROUND
All aspects of mucoepidermoid carcinoma (MEC) of the lung including histologic grading, clinical behavior and its differentiation from adenosquamous cell carcinoma are still not fully understood.
METHODS
We reviewed the hematoxylin-eosin stained slides and medical records of 31 cases of MEC of the lungs. The cases were classified as low and high grade according to the quantitative grading system formulated for MEC. High grade tumors were tested for an epidermal growth factor receptor (EGFR) mutation.
RESULTS
Twenty eight cases were classified as low grade and 3 cases as high grade. Histologically, lower glandular component, cellular atypia, necrosis, mitoses >4/10 high power fields, and endolymphatic tumor emboli were typical characteristics of a high grade tumor. Although some tumors showed histologic features mimicking high grade tumors, they were classified as low grade tumors according to this quantitative grading system. Low grade tumors showed no recurrence or metastasis. However, among three patients with a high grade tumor, two had distant metastases and one died of disease. Additionally, an EGFR mutation was not detected.
CONCLUSIONS
A high grade MEC was consistently different from a low grade tumor with regard to malignant histologic features and poor prognosis. Therefore, correct histologic grading is important in predicting the prognosis to avoid unnecessary treatment.

Citations

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A rare case of endobronchial mucoepidermoid carcinoma of the lung presenting as non-resolving pneumonia
Toolsie Omesh, Ranjan Gupta, Anjali Saqi, Joshua Burack, Misbahuddin Khaja
Respiratory Medicine Case Reports.2018; 25: 154. CrossRef
Cutaneous Involvement by Nasal Mucoepidermoid Carcinoma: The Tip of the Iceberg Phenomenon
Ge Zhao, Oliver Chang, John Streidl, Amit Bhrany, Kyle Garton, Timothy H. McCalmont, Paul E. Swanson, Zsolt Argenyi, Michi M. Shinohara
Journal of Cutaneous Pathology.2017; 44(2): 113. CrossRef
Surgical outcomes of pulmonary mucoepidermoid carcinoma: A review of 41 cases
Chih-Cheng Hsieh, Yung-Han Sun, Shih-Wei Lin, Yi-Chen Yeh, Mei-Lin Chan, Pei-Yi Chu
PLOS ONE.2017; 12(5): e0176918. CrossRef
Clinicopathologic characteristics of EGFR, KRAS, and ALK alterations in 6,595 lung cancers
Boram Lee, Taebum Lee, Se-Hoon Lee, Yoon-La Choi, Joungho Han
Oncotarget.2016; 7(17): 23874. CrossRef
Metastatic Pulmonary Mucoepidermoid Carcinoma with Fulminant Clinical Course
Yong Won Park, Seon Bin Yoon, Mi Ju Cheon, Young Min Koh, Hyeon Sik Oh, Se Joong Kim, Seung Hyeun Lee
The Ewha Medical Journal.2015; 38(2): 85. CrossRef
Lung cancer in never-smoker Asian females is driven by oncogenic mutations, most often involving EGFR
Sang Yun Ha, So-Jung Choi, Jong Ho Cho, Hye Joo Choi, Jinseon Lee, Kyungsoo Jung, Darry Irwin, Xiao Liu, Maruja E. Lira, Mao Mao, Hong Kwan Kim, Yong Soo Choi, Young Mog Shim, Woong Yang Park, Yoon-La Choi, Jhingook Kim
Oncotarget.2015; 6(7): 5465. CrossRef
Bronchoscopic Resection of an Exophytic Endoluminal Tracheal Mass
Russell J. Miller, Septimiu D. Murgu
Annals of the American Thoracic Society.2013; 10(6): 697. CrossRef
EGFR mutations and mucoepidermoid carcinoma: Putative significance in differing populations
Iain D. O’Neill
Lung Cancer.2012; 78(1): 125. CrossRef

The Frequency of BRAF Mutation in Very Small Papillary Thyroid Carcinomas.: Taeeun Kim, Ji Hyun Roh, Hee Jung Park, Jee Eun Kwon, So Young Kang, Yoon La Choi, Young Lyun Oh; Korean J Pathol. 2010;44(3):308-314.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.3.308

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Abstract PDF

BACKGROUND
Papillary thyroid carcinoma (PTC) is the most common malignant tumor of the thyroid and BRAF (V600E) is the most frequent genetic alteration in PTCs. The aim of this study was to investigate the frequency of BRAF mutation, especially in very small PTCs.
METHODS
We analyzed the presence of the BRAF mutation in PTCs in subgroups defined by tumor size (0.5 cm intervals).
RESULTS
Of 140 patients, 85 (60.7%) showed a BRAF mutation. The frequency of BRAF mutation in the subgroup was: 45/70 (64.3%) in tumors less than 0.5 cm in size, 18/28 (64.3%) in 0.6-1 cm tumors, 10/22 (45.5%) in 1.1-1.5 cm tumors, and 12/20 (60.0%) in 1.6-2 cm tumors. There was no statistically significant association between BRAF mutation and tumor size (p = 0.44). Similarly, BRAF mutation was not statistically related to age, sex, stage, perithyroidal extension or lymph node metastasis. On multivariate logistic regression analysis, tumor sizes larger than 0.5 cm were associated with lymph node metastasis (odds ratio, 3.79; 95% confidence interval, 1.81 to 7.91; p < 0.01).
CONCLUSIONS
The BRAF mutation is not related to tumor size even in very small PTCs. The similar frequency of BRAF mutation in very small PTCs suggests that the BRAF mutation is a very early event in the tumorigenesis of PTCs.

Citations

Citations to this article as recorded by

BRAF mutation detection in indeterminate thyroid cytology specimens
N. Paul Ohori, Rashi Singhal, Marina N. Nikiforova, Linwah Yip, Karen E. Schoedel, Christopher Coyne, Kelly L. McCoy, Shane O. LeBeau, Steven P. Hodak, Sally E. Carty, Yuri E. Nikiforov
Cancer Cytopathology.2013; 121(4): 197. CrossRef
BRAFV600E mutation does not serve as a prognostic factor in Korean patients with papillary thyroid carcinoma
Dongbin Ahn, June Sik Park, Jin Ho Sohn, Jae Hyug Kim, Sun-Kyun Park, An Na Seo, Ji Young Park
Auris Nasus Larynx.2012; 39(2): 198. CrossRef
Mutational Patterns and Novel Mutations of the BRAF Gene in a Large Cohort of Korean Patients with Papillary Thyroid Carcinoma
Chan-Kwon Jung, So-Young Im, Yeo-Ju Kang, Hyoungnam Lee, Eun-Sun Jung, Chang-Suk Kang, Ja-Seong Bae, Yeong-Jin Choi
Thyroid.2012; 22(8): 791. CrossRef

Case Reports

Metanephric Adenoma of the Kidney.: Yoon La Choi, Jung Won Lee, Jai Hyang Go, Cheol Keun Park; Korean J Pathol. 1998;32(1):72-75.

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Abstract PDF: Metanephric adenoma is a rare renal epithelial tumor. Its light microscopic features are very characteristic, and immunohistochemical and electron microscopic studies are not critical to the diagnosis. The literature indicate that, to date, the tumor has behaved in a benign fashion, and predominantly but not exclusively occurred in middle-aged women. It occurs in a wide range up to 11 cm and is usually an incidental finding but may be symptomatic with hematuria or flank pain. Recently, we have experienced a case of renal tumor showing distinctive adenomatous features, which is incidentally found in a 52-year-old female. This tumor is confined to the renal cortex and is well-circumscribed with a characteristic uniform and orderly proliferation of compact well-differentiated small tubules lined by bland oval cells with a very low level of mitotic activity. The term metanephric adenoma is appropriate for this tumor because it accurately describes its bland proliferation of tubules and reflects the embryonic architectural and cytological appearance of this proliferation. The pattern of the tumor, with its occasional papillary glomeruloid- like bodies and foci of elongated tubules, is reminiscent of the fetal metanephric kidney.

Soft Tissue Perineurioma.: Yoon La Choi, Dae Soo Kim, Jai Hyang Go, Yeon Lim Suh; Korean J Pathol. 1998;32(11):1028-1031.

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Abstract: Perineurial cells, which normally surround the nerve fascicles within a nerve, can be distinguished from Schwann cells by their immunoreactivity for epithelial membrane antigen (EMA) and lack of reactivity for S-100 protein. Perineurioma is a form of benign peripheral nerve sheath tumor (PNST) almost exclusively composed of perineurial cells. It is often difficult to differentiate this tumor from the other benign PNSTs or ectopic meningioma by histology alone. Immunohistochemical and electron microscopic studies are helpful for differential diagnosis. We recently experienced a case of soft tissue perineurioma in a 14-year-old girl. This tumor was presented as a 5.6 cm sized subcutaneous movable mass in the elbow. The well encapsulated soft tissue tumor consisted of spindle cells which have whorling and storiform patterns within the collagenous stroma. The spindle cells were stained positive for EMA but negative for S-100 protein, chromogranin, neuron-specific enolase or Leu-7. Ultrastructurally, they possessed long cytoplasmic processes with incomplete basal lamina, primitive intercellular junction and occasional pinocytotic vesicles.

Original Article

Pathologic Characteristics of Korean Prostatic Adenocarcinoma: A Mapping Analysis of 60 Cases.: Yoon La Choi, Sung Rim Kim, Sang Yong Song, Han Yong Choi; Korean J Pathol. 2001;35(1):35-40.

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Abstract PDF: BACKGROUND
Pathologic characteristics of the prostatic adenocarcinoma in Korean patients are not clear. We studied 60 cases of radical prostatectomy specimens using mapping analysis in an effort to discover the pathologic characteristics of the Korean prostatic adenocarcinoma.
METHODS
A resected prostate was sectioned serially and embedded near-totally. Gleason score, tumor volume or size, capsular extension, involvement of lateral margin, seminal vesicle, vas, apex and base, presence of lymphatic and neural invasion, and presence of high grade prostatic intraepithelial neoplasm (HGPIN) were examined. DNA ploidy and proliferative index were evaluated.
RESULTS
Mean values were as follows: age, 63.6 years; serum prostate specific antigen level (sPSA), 24.0 ng/ml; tumor amount (volume, 29.1%; size, 2.4 cm); Gleason score, 7.3; aneuploidy, 23.3%; proliferative index, 14.2%. Involvement rates of apex, base, seminal vesicle, resection margin, nerve and lymphatics were 5.2%, 39.0%, 23.7%, 31.7%, 56.7% and 16.7%, respectively. Rates of multifocal tumors and HGPIN were 43.3% and 63.3%, respectively. The Gleason score was correlated with tumor amount (volume%, p<0.001; size, p<0.01) and tumor extent (T) (p<0.005). Tumor amount was correlated with sPSA (p<0.05) and T (p<0.005). T was correlated with sPSA (p<0.05).
CONCLUSION
Korean prostatic adenocarcinomas showed higher Gleason scores, lower HGPIN rates and multifocalities in comparison to western prostatic adenocarcinomas, suggestive of the Korean prostatic adenocarcinomas' late detection.

Case Report

Fine Needle Aspiration Cytology of Solitary Fibrous Tumor of the Pleura: Report of a case misdiagnosed as denocarcinoma of lung.: Yoon La Choi, Young Lyun Oh, Mee Sook Lee, Jung Ho Han, Geung Hwan Ahn; Korean J Cytopathol. 2001;12(2):111-115.

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Abstract PDF: Solitary fibrous tumor of the pleura is rare but should be included in the differential diagnosis of a peripheral pulmonary nodule. Cytologic features of solitary fibrous tumor of the pleura is not familar to the pathologist and may be misdiagnosed as malignancy. We report fine needle aspiration cytologic(FNAC) findings of a case of solitary fibrous tumor misdiagnosed as adenocarcinoma in a 48-year-old woman. The FNAC displayed a mixture of bland-looking spindle cells and clusters of epithelioid cells, which have hyperchromatic nuclei with prominent nucleoli. The helpful finding to distinguish it from other circumscribed benign and malignant lesions is the presence of fibromyxoid matrix admixed with blood vessels and thin collagen fibers. Familiarity with these features is essential to avoid misdiagnosis and overtreatment.

Original Articles

The Expression of G1-S Cell Cycle Inhibitors in Normal Placenta and Gestational Trophoblastic Diseases.: Yan Hua Xuan, Kyung Hee Kim, Yoon La Choi, Geung hwan Ahn, Seoung Wan Chae, Ho chang Lee, Ok Jun Lee, Seok Hyung Kim; Korean J Pathol. 2008;42(2):67-74.

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Abstract PDF: BACKGROUND
The objective of this study is to determine the expression pattern of G1-S inhibitor molecules in normal trophoblasts and gestational trophoblastic diseases, including hydatidiform moles and choriocarcinoma.
METHODS
A total of 157 cases comprising 47 normal placentas and 110 gestational trophoblastic diseases such as choriocarcinoma (19 cases) and hydatidiform moles (91 cases of which 58 were complete, 12 were partial and 21 were invasive mole) were immunohistochemically analyzed on paraffin blocks using anti-p21, antip27, anti-p16, anti-p53, anti-pRb antibodies.
RESULTS
The results revealed that in the normal placenta, all the G1-S cell cycle inhibitors were maximally expressed by the first-trimester trophoblasts and these levels decreased with gestational age. The expression of p21 and p53 was greatly enhanced in the gestational trophoblastic diseases, particularly in invasive mole and choriocarcinoma, whereas the p27 expression was significantly downregulated in choriocarcinoma. Especially, Rb expression was typically enhanced in the invasive mole, but not in choriocarcinoma. The expression level of p16 was low in all the cases, and particularly in choriocarcinoma.
CONCLUSIONS
In conclusion, we demonstrated that the expression of G1/S cell cycle inhibitors correlates well with normal trophoblast differentiation, and these expressions are considerably altered in the gestational trophoblastic diseases, including complete/partial/ invasive hydatidiform mole and choriocarcinoma.

Enhanced CD24 Expression in Colorectal Cancer Correlates with Prognostic Factors.: Yoon La Choi, Hua Xuan Yan, Sang Jeon Lee, Seon Mee Park, Wun Jae Kim, Hee Jin Kim, Seok Hyung Kim; Korean J Pathol. 2006;40(2):103-111.

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Abstract PDF: BACKGROUND
CD24 was originally described as a B cell-specific marker, however its aberrant expression in various solid tumors has recently been reported. Our objective was to determine the pattern and extent of the CD24 expression in colorectal cancer and its related lesions, and to clarify its correlation with clinico-pathological parameters and especially those associated with patients' prognoses.
METHODS
A total of 307 colorectal cancers and the related lesions (150 carcinomas, 30 high-grade adenomas, 49 low-grade adenomas, 41 hyperplastic polyps, and 37 normal colorectal epithelia) were immunohistochemically analyzed by treating CD24 monoclonal antibody onto tissue embedded paraffin blocks.
RESULTS
CD24 expression was very rarely observed in the normal epithelia, hyperplastic polyps, and low-grade adenomas; however, in high-grade adenomas, the CD24 expression was shown to be mildly increased in the cytoplasm (13.3%). In carcinomas, the CD24 expression was increased substantially in both the membrane (38.0%) and the cytoplasm (44.7%). The expression of CD24 in the membrane was positively correlated with tumor size (p<0.01). The CD24 expression in the cytoplasm was positively correlated with several unfavorable parameters, including a larger tumor size (p<0.01), a higher tumor grade (p<0.01), a higher rate of tumor invasion (p<0.05), and a higher pTNM stage (p<0.05).
CONCLUSION
High levels of CD24 expression in the membrane and cytoplasm were characteristic in colorectal cancer, and the cytoplasmic CD24 expression was correlated with several unfavorable clinical parameters.

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