Journal of Pathology and Translational Medicine

Review

The Continuing Value of Ultrastructural Observation in Central Nervous System Neoplasms in Children: Na Rae Kim, Sung-Hye Park; J Pathol Transl Med. 2015;49(6):427-437. Published online October 13, 2015; DOI: https://doi.org/10.4132/jptm.2015.09.19

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Abstract PDF: Central nervous system (CNS) neoplasms are the second most common childhood malignancy after leukemia and the most common solid organ neoplasm in children. Diagnostic dilemmas with small specimens from CNS neoplasms are often the result of multifactorial etiologies such as frozen or fixation artifact, biopsy size, or lack of knowledge about rare or unfamiliar entities. Since the late 1950s, ultrastructural examination has been used in the diagnosis of CNS neoplasms, though it has largely been replaced by immunohistochemical and molecular cytogenetic studies. Nowadays, pathologic diagnosis of CNS neoplasms is achieved through intraoperative cytology, light microscopy, immunohistochemistry, and molecular cytogenetic results. However, the utility of electron microscopy (EM) in the final diagnosis of CNS neoplasms and investigation of its pathogenetic origin remains critical. Here, we reviewed the distinguishing ultrastructural features of pediatric CNS neoplasms and emphasize the continuing value of EM in the diagnosis of CNS neoplasms.

Original Article

Comparison of Pathologic Findings of Cortical Lobectomy for Intractable Seizures between Children and Adults: An Analysis of 164 Cases.: Na Rae Kim, Yeon Lim Suh; Korean J Pathol. 1999;33(12):1175-1181.

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Abstract PDF: Many pathological surveys of brain tissue in patients with intractable epilepsy have been reported. There have been, however, few studies focused on the differences between childhood and adults in pathological alterations of brain. We retrospectively analyzed histopathology of 164 lobectomy specimens for intractable epilepsy in view of the differences between children and adults. Among 164 cases, 28 cases were children (less than 15 years) and 136 cases adults. We compared frequency of histopathologic features, distribution of involved cortex (temporal or extratemporal lobe), previous injury histories, such as brain trauma, encephalitis or febrile seizure, and coexistence of other lesions (dual pathology) between two groups. Pathologic alterations were encountered in 92% of 164 patients. In children focal cortical dysplasia (n=16, 57.1%), neoplasm (n=8, 28.6%), hippocampal sclerosis (n=6, 21.4%), cortical tuber (n=1, 3.6%), leukomalacia (n=1, 3.6%), and Rasmussen's encephalitis (n=1, 3.6%) were observed, whereas focal cortical dysplasia (n=81, 59.6%), hippocampal sclerosis (n=80, 58.8%), neoplasm (n=19, 14%), and cerebral cysticercosis (n=3, 2.2%) were found in adults. Pediatric patients had a higher proportion of severe focal cortical dysplasia (17.9% in children, 0.7% in adults). Neoplasia and extratemporal lobe involvement were more commonly found in children (28.6%, 50%) than in adults (14.0%, 24.3%), whereas hippocampal sclerosis and dual pathology were more common in adults (58.8%, 44.9%) than in children (21.4%, 17.9%). Previous injury history was statistically significant in patients with hippocampal sclerosis, and lent support to the hypothesis that hippocampal sclerosis is related with acquired lesions. Incidence of focal cortical dysplasia was nearly similar in both adult (59.6%) and pediatric groups (57.1%), and supported the hypothesis that focal cortical dysplasia is developmental abnormality occurring during a prenatal period.

Case Reports

Clear Cell Meningioma arising from Lumbar Nerve Root in a Child: A case report.: Eun Kyung Hong, Geun Shin Lyu, Moon Hyang Park; Korean J Pathol. 1994;28(2):179-184.

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Abstract PDF: Meningioma of unusual age of onset, location, histogenesis and histologic type is reported. The patient, 4 year-old girl, had an intradural spinal meningioma arising from lumbar nerve root with no dural attachement. The meningioma revealed glycogen-rich, clear cell type with extensive and blocky hyalinization of the stroma. The tumor shared common fibrous sheath with attached lumbar nerve, and nerve fibers were scattered within the tumor. Ultrastructurally, the tumor cells had abundant glycogen particles, intermediate filaments and intercellular desmosomes. Hyalinized material revealed large amianthoid collagen fibers.

Signet Ring Cell Carcinoma of Stomach in Child: Report of a case.: Kyeong Mee Park, Ill Hyang Ko; Korean J Pathol. 1994;28(1):102-105.

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Abstract PDF: Cancer of the alimentary tract in children is an extremely rare occurence, and it accounts for no more than 5% of all pediatric neoplasms. Malignant neoplasms of the stomach are particularly uncommon in childhood. The majority of such lesions are malignant lymphomas or soft tissue sarcomas, with less than 5% identified as carcinomas. We report a case of signet ring cell carcinoma of stomach in 15-year-old girl. This patient had a clinical manifestation of cough with sputum, fever, abdominal distension due to ascites, hepatomegaly, and cervical lymphadenopathy for 40 days. There was no known gastrointestinal symptoms. Metastatic signet ring cell carcinoma was suspected by aspiration biopsy cytology of cervical lymph node, and confirmed later by excisional biopsy. Endoscopy confirmed a small mucosal erosion in the anterior wall of the antrum and histopathology confirmed the diagnosis of signet ring cell carcinoma.

Neuroendocrine Differentiation in Adrenal Cortical Tumor of Chidhood: A case report.: Sang Yong Song, Seung Sook Lee, Na Hye Myung, Je G Chi; Korean J Pathol. 1993;27(2):175-180.

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Abstract PDF: Although neuroendocrine differentiation is a characteristic feature of tumors of the adrenal medulla, cortical tumors may also rarely be differentiated into medullary element. Recently we experienced such a case of adrenal cortical tumor having features of both cortical and medullary tumor. The patient was an 11-year-old girl who was incidentally found to have a left adrenal mass. Laboratory results showed elevated serum cortisol, aldosterone, renin, and epinephrine with high excretion of urinary metanephrine. Urine vanillyl mandelic acid and 17-ketosteroid remained within normal limits. Histologic featuresof a 6 cm round yellowish tumor were ambiguous to decide the orgin of this neoplasm. Cortical element predominated in the tumor with minor areas of pheochromocytomatous feature. Immunohistochemically, the tumor cells were positive for vimentin, neuron specific enolase, and epithelial membrane antigen. Ultrastructural examination revealed scattered membrane bound dense core granules in the tumor cells of medullary differentiation, measuring 150~500 nm in average diameter. Cortical tumor element showed corresponding ultrastructural features. These results indicate that this is a case of adrenal cortical tumor with features of neuroendocrine differentiation.

Pulmonary Arteriovenous Fistula in Childbood: Report of a case.: Soo Min Kang, Mi Kyung Kim, Je G Chi; Korean J Pathol. 1992;26(2):201-203.

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Abstract PDF: A case of pulmonary arteriovenous fistula in a 8-year-old boy who presented with easy fatigability and cyanosis for 4 months, is described. Grossly, there was a large vascular anomaly measuring 2x2 cm in the center of the removed right lower lobe. Microscopically, the lesion consisted of dilated arterial and venous structures resembling a cavernous hemangioma. Subintimal fibrosis and attenuated vascular structure lacking elastic fiber and representing A-V shunt were also noted in the lesion.

Juvenile Cellular Adenofibroma of Breast: A case report.: Je G Chi, Yeon Lim Suh; Korean J Pathol. 1989;23(2):269-272.

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Abstract PDF: Juvenile cellular adenofibroma of the breast is a unique neoplasm of the breast that should be differentiated from other important benign and malignant lesions of the juvenile breasts. We report a case with it's characteristic clinical, gross and histological features. The tumor was in the right breast with the size of 20 cm in maximum extent. This patient was also associated with hemihypertrophy of the right side. Microscopically the masses were characterized by prominent stromal cellularity associated with pericanalicular duct proliferation.

Original Article

Hepatic Changes Resembling the Indian Childhood Cirrhosis in an IgM anti-CMV Positive Infant.: Soo Im Choi, Chan Il Park, Ki Sup Chung; Korean J Pathol. 1987;21(2):90-93.

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Abstract PDF: This is to describe a neonatal hepatitis with pericellular hepatic fibrosis and Mallory bodies in a sero-positive infant for IgM anti-CMV. A necropsy of the liver revealed severe heaptocellular swelling with many intracytoplasmic hyaline bodies, pronounced fibrosis of a creeping type, bile stasis with ductular proliferation, and the lack of parenchymal regeneration. These microscopical changes of the liver resembled those of Indian Childhood Cirrhosis (ICC). In the present case the patient's serum IgM anti-CMV is the only clue for the etiological diagnosis.

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