- Porposal for Creating a Guideline for Cancer Registration of the Gastrointestinal Tumors (I).
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Mee Yon Cho, Yun Kyung Kang, Kyoung Mee Kim, Hee Kyung Chang, Hee Jin Chang, Mee Soo Chang, Joon Mee Kim, Dae Young Kang, Chanil Park, Jin Hee Sohn
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Korean J Pathol. 2008;42(3):140-150.
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- BACKGROUND
Cancer registries are fundamental for cancer control and multicenter collaborative research. However, there have been discrepancies among pathologists in classifying cancer and assigning the codes according to the International Classification of Disease Oncology 3 (ICD-O3).
To improve the quality of cancer registries as well as to prevent the conflict with medical insurance compensation, a guideline for the coding of cancer is mandatory.
METHODS
AND RESULTS: Funded by the Management Center for Health Promotion, 40 members of the Gastrointestinal Pathology Study Group and the Cancer Registration Committee of the Korean Society of Pathologists participated in the 1st workshop for gastrointestinal tumor registration. The subjects of gastric epithelial tumor, intramucosal carcinoma of the colon, carcinoid tumor, gastrointestinal stromal tumor and appendiceal mucinous tumor were discussed to create a guideline. A survey to obtain consensus for the guideline proposed by the workshop was carried out by the members of the Korean Society of Pathologists and 240 members completed the questionnaire.
CONCLUSION
Although there are some issues to be discussed further, such as coding of high grade dysplasia/adenoma and intramucosal carcinoma of stomach and colon, the members agreed upon most parts of the proposed guideline. Therefore, we suggest using the ICD-O3 coding guideline for gastrointestinal tumor.
- Adrenocortical Oncocytoma: A Case Report.
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Hun Soo Kim, Dae Young Kang
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Korean J Pathol. 2007;41(5):329-333.
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- Adrenocortical oncocytomas have rarely been reported on in the medical literature, and most of them have been nonfunctional and benign. We report here on a case of a 43-year-old man with a left abdominal mass. The patient showed no signs of hypertension or hormonal imbalance. The abdominal CT scans showed a huge mass that measured 11 cm in diameter, and it was located at the left adrenal area.
Grossly, the tumor was well encapsulated and homogenous with central necrosis. Microscopically, the tumor was composed of oncocytes with abundant granular cytoplasm.
Immunohistochemically, these cells were diffusely positive for cytokeratin and focally positive for synaptophysin and NSE. The ultrastructural studies showed numerous mitochondria in the cytoplasm. We will discuss the criteria that indicates malignancy as presented by Weiss et al. and we summarize the difference between conventional and oncocytic adrenocortical neoplasm. This case showed some features of malignancy based on the criteria presented by Weiss et al.
- Sarcomatoid Carcinoma of the Pancreas: A Case Report.
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Kyung Hee Kim, Dae Young Kang, Min Koo Lee, Hyeon Woong Yang, Hyun Young Han
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Korean J Pathol. 2006;40(4):306-310.
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- We report here on an unusual case of a 73-year-old Korean female with sarcomatoid carcinoma. This tumor was composed of pancreatic ductal adenocarcinoma and a malignant fibrous histiocytoma-like stroma. The CT imaging revealed a multiseptated heterogenous hypodense mass that was 15 cm in size. The mass was located in the body and tail of the pancreas, spleen and gastrosplenic area. The pathologic examination showed that the carcinomatous component was negative for vimentin, and the sarcomatous component was positive for vimentin and CD 68. The ultrastructural examination showed that both the carcinomatous and sarcomatous components had desmosomes at the cell-cell contact sites. The patient refused postoperative adjuvant chemotherapy and she died of cachexia with generalized tumor extension about 3 months later. This report presents special data that can clarify the clinicopathological features and pathogenesis of this rare neoplasm.
- Usefulness of Galectin-3, Cytokeratin 19, p53, and Ki-67 for the Differential Diagnosis of Thyroid Tumors.
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Moon Il Park, Dae Young Kang
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Korean J Pathol. 2006;40(2):86-92.
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- BACKGROUND
The expressions of galectin-3, cytokeratin 19, p53, and Ki-67 in papillary carcinoma (PC), follicular carcinoma (FC), follicular adenoma (FA), and nodular hyperplasia (NH) are characteristic for the differential diagnosis between benign and malignant thyroid tumors.
METHODS
The expressions of the four markers were evaluated in PC (n=37), FC (n=12), FA (n=22), and NH (n=23) by immunohistochemical staining.
RESULTS
Statistical analyses revealed that galectin-3 was significantly expressed in the malignant tumor cells of PC and FC, while CK19 was expressed only in PC.
CONCLUSION
These results show that galectin-3 is useful in differential diagnosis between malignant and benign thyroid lesions, especially between FC and FA in the patients over 20 years old, and indicate that CK19 is valuable in differentiating between follicular variant of PC and FC and between PC and papillary area of nodular hyperplasia.
- Histiocytic Sarcoma of Rectum: A Case Report.
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Moon Il Park, Kyu Sang Song, Dae Young Kang
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Korean J Pathol. 2006;40(2):156-159.
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- We present a case of a 44 year-old man with histiocytic sarcoma arising from the rectum. Histiocytic sarcoma is a rare type of malignant lymphoma, comprising less than 0.5% of all non-Hodgkin's lymphomas (NHLs). In this case, the tumor was a polypoid mass, measuring 2.5 x 2 cm. On microscopic examination, it was composed of many bizarre multinucleated cells and sheets of xanthomatous histiocytes.
There were also areas with spindle cells arranged in a storiform pattern. Extensive metastases to regional lymph nodes were found, and combined adjuvant chemotherapy was administered after complete resection.
- Pathologic Comparative Studies on the Protective Effects by Panax Ginseng and Panax Quinquefolium for Treating 2,3,7,8-tetrachlorodibenzo-p-dioxin-induced Toxicity in Male Rats.
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Dae Young Kang, Moon Il Park, Sun Young Na, Jae Joon Wee
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Korean J Pathol. 2006;40(2):118-127.
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- BACKGROUND
Panax ginseng is known to decrease the 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)-induced testicular toxicity. Thus, we aimed to reveal the differences between Panax ginseng and Panax quinquefolium extract for their effects on TCDD-induced toxicity.
METHODS
Forty rats were divided into four groups; the control group, the TCDD only group, the TCDD plus Panax ginseng group, and the TCDD plus Panax quinquefolium-treated groups. Ginseng extract was given orally to rats from day one to twenty-one. TCDD was intraperitoneally administered to rats at a single dose of 50 microgram/kg on the seventh day. The pathologic changes were then examined. The changes of body weight, cholesterol and GOT in the serum were also examined.
RESULTS
The TCDD toxicity was prominent in the thymus, liver and testis. The thymus showed atrophy and an inverse pattern of lymphocyte density in the cortex and medulla. The liver revealed central necrosis with fatty changes. On electron microscopy, the seminiferous tubules showed destruction of the spermatogonia, clear spaces or vacuolar changes and degeneration in the Sertoli cells or germ cells.
The above mentioned TCDD-induced changes were reduced in the rats that were administered with Panax ginseng, whereas Panax quinquefolium did not reduce these changes.
CONCLUSION
The protective effects of Panax ginseng on the TCDD-induced toxicity were more effective than those of Panax quinquefolium.
- Paratesticular Papillary Serous Tumor of Low Malignant Potential: A Case Report.
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Moon Il Park, Hun Soo Kim, Kwang Sun Suh, Dae Young Kang
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Korean J Pathol. 2004;38(6):427-429.
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- Paratesticular papillary serous tumors have been rarely reported, and they often resemble ovarian serous tumors of borderline malignancy. We experienced a case of papillary serous tumor in the left paratestis of a 39-year-old man.
This is the second case reported in the Korean literature.
The tumor, which was found incidentally during an operation for a hydrocele, was composed of papillary structures lined by cuboidal to columnar epithelial cells that displayed low cytologic atypia and frequent psammoma bodies.
- The Effect of Splenectomy on Acute Barium Sulfate Induced Toxicity of Rat Organs.
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Hae Joung Sul, Dae Young Kang
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Korean J Pathol. 2004;38(4):249-257.
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- BACKGROUND
The purpose of this study was to elucidate whether or not splenectomy alters the acute toxic effects on rat tissue induced by barium sulfate.
METHODS
A total of 80 Sprague-Dawely male rats were divided into three groups; the control group and the barium sulfate treated groups with and without splenectomy. The pathologic changes in the solid organs were examined at the time after intraperitoneal treatment with barium sulfate. The changes of white blood cell count were also examined.
RESULTS
The barium induced toxicity was most prominent in the spleen. The changes in the other organs were proportional to the experimental duration, and the changes in the barium only treatment group were more severe than the observed changes in the splenectomy and barium treated group.
CONCLUSIONS
These results suggest that the degree of barium toxicity of barium only treated group was more severe than that of the splenectomy group.
- c-kitMutation and Immunohistochemical Expression in Gastrointestinal Stromal Tumors.
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Dong Wook Kang, Joo Heon Kim, Dong Hun Kim, Kung Hee Kim, Mee Ja Park, Dae Young Kang
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Korean J Pathol. 2003;37(4):246-254.
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- BACKGROUND
Gastrointestinal stromal tumor (GIST) is the most common non-epithelial neoplasm arising in the gastrointestinal tract. The aim of this study is to investigate the correlation among the clinicopathologic features, presence of c-kit mutation, and immunohistochemical expression of c-kit in 61 cases of GISTs.
METHODS
We divided the GISTs into three groups as benign, boderline and malignant, according to histologic grade. Exon 11 of the c-kit was amplified by PCR and sequenced. We performed immunohistochemical study for CD117, CD34, vimentin, SMA, desmin, and S-100 protein.
RESULTS
Twenty-one cases were diagnosed as benign GISTs, 14 cases as borderline GISTs, and 26 cases as malignant GISTs.
The shape, atypia, cellularity, and necrosis showed good correlations with the histologic grades of the GISTs.Mutations of exon 11 of the c-kit were detected in 3 benign GISTs, 4 borderline GISTs, and 13(%) malignant GISTs.
Sequence analysis confirmed the deletion mutation (n=16) and the singlebase pair mutation (n=4). The immunohistochemical stainings showed myogenic differentiation(n=20), neurogenic differentiation (n=15), and neither myogenic or neurogenic differentiation(n=34).
CONCLUSIONS
The GIST is the primitive mesenchymal tumor capable of divergent differentiation, and the mutation of the c-kit is a good parameter for the malignant GIST.
- Prevalence and Clinicopathologic Features of Mucinous Cystic Tumor and Intraductal Papillary Mucinous Tumor of Pancreas in Korea.
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Jin Hee Sohn, Kyung Me Kim, Seoung Wan Chae, Woo Ho Kim, Woo Sung Moon, Young Nyun Park, Chul Gun Park, Eun sil Yu, Hee Kyung Jang, Hee Jin Jang, Jong Jae Jung, Jin Sook Jung, So Young Jin, Jong Sang Choi, Dae Young Kang
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Korean J Pathol. 2003;37(4):270-278.
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- BACKGROUND
Mucin producing cystic neoplasms, such as mucinous cystic tumor (MCT) and intraductal papillary mucinous tumor (IPMT) of the pancreas, are uncommon but become increasing in their incidences. The pathologic classification and biologic potential of these neoplasmsremain the subject of controversy.
METHODS
The Gastrointestinal Pathology Study Group of the Korean Society of Pathologists analyzed the clinicopathologic characteristics of 85 casesof MCT and 72 cases of IPMT and examined the expression patterns of p53, CEA and MUC1.
RESULTS
IPMT was located largely in the head, and showed connection with the main pancreatic duct (MPD, 68.1%), no ovarian-like stroma (0/72), and presence of intervening intratumoralnormal or atrophic parenchyma. On the other hand, MCT was located largely in thetail (73%), and showed common ovarian-like stroma (66/80), rare connection with the MPD(7/85) and no intervening pancreatic parenchyma. CEA and p53 immunoexpressions weresignificantly increased from adenoma through borderline to carcinoma, but MUC 1 was expressedonly in the invasive carcinoma among cases of MCT and IPMT.
CONCLUSIONS
The tumorlocation, ovarian-like stroma, connection with the MPD and intratumoral intervening nonneoplastictissue were helpful in the differential diagnosis between IPMT and MCT. CEA and p53expressions can be indicators of malignancy, while MUC 1 expression can indicate invasion.
- Localized Malignant Mesothelioma of Peritoneum Arising in the Liver Capsule: A Case Report.
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Hae Joung Sul, Dae Young Kang
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Korean J Pathol. 2003;37(1):74-77.
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- Mesothelioma originates in several sites including the pleura, peritoneum, pericardium, and tunica vaginalis. The pleura is the most common site of origin, but cases originating in the per- itoneum is relatively rare.
Mesothelial lesions of the peritoneum may pose significant diagnostic problems. Yet, the accurate identification of this lesion is important because of its distinctive behavior and treatment modality. We herein report a case of malignant mesothelioma of the peritoneum arising in the capsule of the liver. The accuracy of our diagnosis has been confirmed by the immunohistochemical study and electron microscopic examination.
- Malignant Gastrointestinal Stromal Tumor of the Esophagus: A Case Report.
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Hae Joung Sul, Kyeong Hee Kim, Dae Young Kang
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Korean J Pathol. 2001;35(3):252-255.
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- Gastrointestinal stromal tumors (GISTs) predominate in the stomach and small intestine but have rarely been documented in the esophagus. We report a rare case of GIST of the esophagus in a 47-year-old woman. Histologically, the tumors showed a combination of solid, myxoid, and perivascular collar-like patterns, with spindle and epithelioid cells.
The tumor cells were positive for CD117, CD34, and S-100 protein and negative for desmin and -smooth muscle actin.
- Does the Colorectal Cancer Among Koreans Share the Same Pathological Features by Geographical Distribution: A Nationwide Survey of Surgically Resected 1,676 Cancers from 1,602 Patients.
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Mee Soo Chang, Jin Hee Sohn, Dae Young Kang, Gyeong Hoon Kang, Myung Sook Kim, Woo Ho Kim, Jong Hee Nam, Woo Sung Moon, Sun Hoo Park, Cheol Jeun Park, Ro hyun Sung, Young Lyun Oh, Eun Sook Chang, Hee Kyung Chang, Mee Yon Cho, Kyung Ja Cho, Yong Il Kim
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Korean J Pathol. 2001;35(1):14-19.
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- BACKGROUND
This nationwide survey was undertaken to characterize the general pathological features of colorectal cancer in Korea, and especially to elucidate the geographical characteristics by means of their anatomical distribution.
METHODS
We analysed 1,676 colorectal cancers (from 1,602 patients) surgically resected in 1998 at 15 institutions from nine geographical sites in Korea.
RESULTS
The topographic incidence of colorectal cancer in seven out of the total nine geographical sites, was the highest in the rectum (32-54%); and those from Wonju and Cheongju were in the sigmoid colon (28% for both). The right colon cancer incidence was 42% in Wonju and 36% in Cheongju, while it was 17-22% in the other areas. The cecal cancer incidences in Wonju and in Taegu were 7% and 8%, respectively, but 0-4% in the other areas. As for histology, moderately differentiated adenocarcinoma was the most frequent (46-84%), except for in Wonju and Chonju, where the most predominant type was well differentiated (63% and 52%, respectively).
CONCLUSION
The incidence of right colon cancer was higher in Wonju and Cheongju, than in the other geographical sites.
The cecal predilection was prominent in Taegu and Wonju. The Elucidation of geographical differences in degree of differentiation for tubular adenocarcinoma seems to require further cumulative study with strict guidelines.
- Apoptosis in Rat Thymus after Bolus Intramuscular Injection of 5-Fluorouracil.
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Kyung Hee Kim, Hae Joung Sul, Dae Young Kang
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Korean J Pathol. 2000;34(6):413-418.
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- We induced apoptosis in normal rats by intramuscular injection of 5-fluorouracil (5-FU) and immunohistochemically evaluated the thymus for the TdT-mediated dUTP biotin nick end labelling on the 1st, 3rd, 6th, 9th, 15th and 21st days following the bolus intramuscular injection. The injections of 5-FU induced a greater extent of apoptosis in the thymus. In the thymus, a mild increase in apoptosis was observed 24 hours after injection. The greatest number of apoptotic cells were seen at 72 hours. The size of the thymus decreased and the cortex thinned with hypocellularity. The injection of 5-FU caused massive cell loss in the thymus. Most apoptotic cells were scattered in the cortex and lower levels of apoptosis were also observed in the medulla. After 72 hours, the level of apoptosis returned to the control level.
Considering the above results, we think that 5-FU induced toxicity may be related to 5-FU induced apoptosis in normal tissue, especially the thymus.
- Chronic Hepatitis in the Idiopathic Hypereosinophilic Syndrome: A case report .
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Kyeong Hee Kim, Hae Joung Sul, Sung Chul Jun, Dae Young Kang
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Korean J Pathol. 1999;33(8):624-626.
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- Chronic hepatitis associated with the idiopathic hypereosinophilic syndrome has been very rarely reported worldwide. Recently, we experienced a case of chronic hepatitis with piecemeal necrosis as the clinical feature of the idiopathic hypereosinophilic syndrome. The patient was a 49-year-old woman who complained of a mild fever, nausea, vomiting, and pain in the right upper quadrant. The eosinophil count of peripheral blood increased up to 14,020/microliter (64% of WBC). Liver biopsy specimen showed severe porto-periportal inflammation with marked eosinophilic infiltration and ballooning degeneration of hepatocytes. Corticosteroid therapy significantly normalized the eosinophil count of peripheral blood.
- Histological Grading and Staging of Chronic Hepatitis Standardized Guideline Proposed by the Korean Study Group for the Pathology of Digestive Diseases .
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Young Nyun Park, Ho guen Kim, Chae Yoon Chon, Jae Bok Park, Jin Hee Sohn, Seung Ha Yang, Eun Sil Yu, Mi Seon Lee, Ja June Jang, Hee Kyung Chang, Jong Jae Jeong, Dae Young Kang, Yong Il Kim, Chan Il Park
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Korean J Pathol. 1999;33(5):337-346.
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- The terms chronic active hepatitis (CAH), chronic persistent hepatitis (CPH), and chronic lobular hepatitis (CLH) should be discontinued in favor of etiologic terminology.
The activity of necro-inflammation and the degree of fibrosis should be evaluated for grading the severity and for the stage of disease. Members of the Korean Study Group for the Pathology of Digestive Diseases reviewed 30 cases of chronic hepatitis and reached the following consensus: 1) The pathology report of the biopsy samples with features of chronic hepatitis should include the etiology, grade and stage. 2) Grade and stage should be semiquantitatively evaluated as none, minimal, mild, moderate and severe. 3) For grading, lobular activity and periportal activity should be evaluated, separately. 4) To avoid confusion with other grading systems, simple report using descriptive terms rather than numerical records is recommended in daily practice.
Criteria for each grade and stage should be presented and discussed. Histologic grading and staging of chronic hepatitis by new standardized guidelines will give more information about the prognosis as well as the present status of hepatitis. The terms CAH, CPH and CLH may be used in parentheses to facilitate relearning.
- Primary Malignant Fibrous Histiocytoma of the Liver: A case report.
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Bum Kyeong Kim, Kyeong Hee Kim, Hye Jeong Sul, Dae Young Kang
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Korean J Pathol. 1999;33(1):48-51.
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- Malignant fibrous histiocytoma (MFH) of the liver is uncommon, representing less than 1% of the primary malignant lesions of the liver. We report primary MFH of the liver in a 59-year-old woman. The tumor, measuring 9.0 9.0 6.0 cm, was located in the left lobe of the liver. It showed multiple areas of hemorrhage and necrosis. Microscopically, the tumor consisted of plump spindle cells haphazardly arranged in short fascicle and focal storiform pattern.
Multiple bizarre giant cells were also noted.
Immunohistochemically, many of the tumor cells were positive for vimentin and alpha1-antitrypsin but negative for epithelial markers. Ultrastructurally, the tumor cells showed fibroblastic and histiocytic features.
- Gastrointestinal Polyposis in Koreans: A Nationwide Survey of Clinicopathologic Analysis of 112 Surgically Resected Cases.
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Mee Soo Chang, Hoguen Kim, Woo Ho Kim, Chan Il Park, Eun Kyung Hong, Han Kyeom Kim, In Soo Suh, Byung Kee Kim, Ja June Jang, Woon Sub Han, Hyung Sik Shin, So Young Jin, Dae Young Kang, Yong Il Kim
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Korean J Pathol. 1998;32(6):404-412.
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Abstract
- Gastrointestinal polyposis (GIP) is a rare disease characterized by formation of the numerous polyps in the gastrointestinal tract and presenting several extraintestinal manifestations. Most of the diseases are transmitted in an autosomal dominant pattern. In Korea, the epidemiological study as well as the pathological analysis of the GIP is not well established. We therefore analysed 38 items of GIP using surgically resected specimens. The materials in this study were collected from the 12 institutions and case reports in Korean literature between 1980 and 1991. The clinicopathologic findings were reevaluated by several members of the study group for gastrointestinal pathology. The results are as follows: (1) A total of 112 cases were included in this study: 83 cases were collected from 12 institutions and 29 cases were collected from Korean literature. The cases were classified as familial adenomatous polyposis (FAP), 59 cases; Gardner's syndrome, 3 cases; juvenile polyposis, 12 cases; Peutz-Jeghers syndrome, 35 cases; multiple colonic adenomas, 3 cases. (2) Among 59 cases of FAP, the range of age at operation was 14 to 61 years, and a family history was positive in 25 cases. The number of polyps in colorectum was 100~8,000. Of the 37 cases in which the examination of polyp density was available, 16 cases (43%) showed the highest density in the rectum and the sigmoid colon. The carcinomatous change within polyp(s) was present in 18 cases (31%), and associated advanced single or multiple colonic carcinomas existed in 37 cases (63%). Twenty-six (45%) tumors out of total 58 carcinomas were in the rectum.
Twenty-five patients were evaluated for the upper gastrointestinal lesions, and 11 patients (44%) had pathologic lesions; multiple fundic gland polyps in 3 cases (12%), gastric and duodenal adenomas in 2 cases (8%), gastric adenomas in 2 cases (8%), duodenal adenomas in 2 cases (8%), gastric carcinoma and adenoma in 1 case (4%), gastric carcinoma in 1 case (4%). (3) Among 3 cases of Gardner's syndrome, the range of age at operation was 25 to 31 years, a family history was identified in 2 cases. One case was associated with an advanced colonic carcinoma and carcinomatous change within polyp. Extra gastrointestinal lesions were sebaceous cyst, epidermal cyst, osteoma and desmoid tumor. (4) Among 12 juvenile polyposis, the range of age at operation was 8 to 51 years and 5 patients had a family history. The carcinomatous change within polyp was found in 2 cases (17%) and associated advanced colonic carcinoma was in 4 cases (33%). The associated different type of polyps was tubular adenomas in 9 cases (75%), hyperplastic polyps in 4 cases (33%) and villous adenomas in 2 cases (17%). (5) Among 35 Peutz-Jeghers syndrome, the range of age at first operation was 6 to 42 years, family history was positive in 11 cases. The carcinomatous change within polyp was found in 1 case (3%), and associated advanced colonic carcinoma in 1 case (3%). The epithelial misplacement was observed in 4 cases (11%), and tubular or villous adenomatous feature in 4 cases (11%). In summary, the most frequent GIP for the surgical resection in Korea is FAP and the FAP is associated with high incidence of coexisting advanced and intramucosal carcinomas.
Hamartomatous polyposis syndromes, such as juvenile polyposis and Peutz-Jeghers syndrome are another frequent disease for the surgical resection and are also associated with an increased risk of cancer.
- Mediastinal Hemangioma: Report of a case.
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Jong Ok Kim, Bum Kyeong Kim, Kyoung Hee Kim, Dae Young Kang, Kwang Sun Suh
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Korean J Pathol. 1997;31(9):891-894.
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- Benign hemangioma of the mediastinum is rare. This slowly growing tumor is described as well circumscribed, cystic, hemorrhagic tumor. Histologically it can be differentiated into capillary or cavernous form. We present a case of mediastinal hemangioma. A 20-year-old-man was presented with a slowly growing posterior mediastinal mass of 6 years duration, 8x6 cm in size. The mass was relatively well defined but focally invasive. Microscopically, it was differentiated into vessels of capillary, cavernous, and venous patterns. A solid cellular proliferation with inconspicuous capillary lumens was focally seen. The stroma between variable-sized vessels showed marked myxoid change associated with some smooth muscle bundles and adipose tissue. Ultrastructurally, areas of solid cellular proliferation showed formation of lumens. These lumens were lined by active endothelial cells showing plasmalemmal vesicles and Weibel-Palade bodies on the abluminal surface.
- Congenital Mesoblastic Nephromas with lmmunohistochemical and Flow Cytometric Analysis.
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Woo Hee Jung, Yee Jeong Kim, Jee Young Han, Woo Ick Yang, Dae Young Kang
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Korean J Pathol. 1995;29(3):303-310.
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- We reviewed 7 cases of congenital mesoblastic nephroma (4 cases of classical mesoblastic nephroma (CMN) and 3 cases of atypical mesoblastic nephroma (AMN)) using immuno-histochemical and flow cytometric study. Results are as follows. 1) The mean tumor size was 5 (3 to 7cm)cm in CMN and 9 (7 to 10cm)cm in AMN. The AMN revealed hemorrhage and necrosis in two Of three cases. A case of AMN showed cystic change without hemorrhage and necrosis. Mitotic count ranged in 0~4/10HPF in CMN and 20-35/10HPF in AMN. 2) Immunohistochemistry for vimentin was all positive. Actin, desmin were weakly positive in CMN, but negative in AMN. The findings were consistent with myofibroblastic differentiation in CMN and AMN was considered to be the less differentiated form of CMN. 3) Flow cytometiic analysis showed diploidy in two of two CMNs and two of three AMNs.
Only one AMN showed aneuploidy with DNA index of 1.41. %SG2M were 8.1 and 15.9 (mean 12.0) in CMN and 16.9, 32.9 and 19.3 (mean 22.9) in AMN, respectively. We concluded that AMN should be distinguished from CMN, clinicopathologically.
- Fine Needle Aspiration Cytology of Endodermal Sinus Tumor of the Ovary: A Case Report.
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Jin Man Kim, Dae Young Kang
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Korean J Cytopathol. 1995;6(1):54-57.
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- We report a case of fine needle aspiration cytology of endodermal sinus tumor of the ovary. A 13-year-old girl complained of abdominal mass and pain. The abdominal sonography revealed a well-demarcated huge mass, which was solid and multiseptated. Percutaneous fine needle aspiration was performed from the mass. The smears revealed moderate cellularity, which was arranged in sheets or clumps of pleomorphic malignant cells on mucoid background. The valuable characteristic features of tumor cells were papillary configuration, vacuolated cytoplasm and intracellular and extracellular hyaline globules. The diagnosis was confirmed later by histologic study of surgical resection of the specimen.
- Effect of Eicosapentaenioc acid and Butyrated hydroxyanisole on Hypercholestrolemic Diet Induced Atherogenesis in Rabbit.
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Choong Sik Lee, Jeung Mok Choi, Sung Ki Min, Kyu Sang Song, Dae Young Kang, Kyu Lym
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Korean J Pathol. 1994;28(3):235-245.
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Abstract
- It has been suggested that the fish oil can reduce atherogenesis in humans and animals, and that peroxidation of lipoproteins may be a major factor causing atherosclerotic lesions. We tested these posibilities in rabbits fed an atherogenic diet by comparing the effect of a eicosapentaenoic acid(EPA: a major component of fish oil)supplement and a butyrated hydroxyanisole(BHA: antioxidant)diet supplement. Tweenty-eight young male New Zealand White rabbits were used in this study. The animals were divided by control, cholesterol fed only, cholesterol + EPA, and cholesterol + BHA groups. The experimental course lasted 12 weeks and animals were sacrificed periodically(2, 5, 8, 12weeks)for quantitative studies of aortic atherosclerosis using light and electron microscopy. Plasma cholesterol levels were determined and lipopreteins were separated periodically. The cholesterol fed only group showed an increased serum cholseterol level and atherosclerotic lesions from 5 weeks of experiments. The EPA supplement resulted in similiar serum cholesterol levels with cholesterol fed only group, but greater lesion than cholesterol fed only group. The BHA supplement resulted in higher serum cholesterol levels except VLDL-cholesterol than EPA supplement group. However, the atherosclerotic lesion was not increased. Our studies support the theory that oxidative modification of lipoproteins is important for the atherogenesis and antioxidant may have a protective effect.
However, it failed to show antiatherogenesis effect of fish oil.
- Pleomorphic Xanthoastrocytoma: A Case Report.
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Seong Ki Min, Dong Wook Kang, Kyu Sang Song, Dae Young Kang, Seong Ho Kim
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Korean J Pathol. 1993;27(6):666-669.
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- Pleomorphic xanthoastrocytoma is histologically characterized by marked cellular pleomorphism of lipid-laden neoplastic astrocytes and bizarre giant cells showing mitotic figures and high cellularity. Inspite of its ominous-looking microscopic features, howerver, the prognosis is usually favorable. This tumor develops mainly in the supratentorial area of young people and frequently involves the leptomeninges. We experienced a case of pleomorphic xanthoastrocytoma in 18 year-old-male. In addition to the cellular pleomophism, the prominent reticulin fibers surround the individual tumor cells or the tumor cells nests. Immunohistochemical staining and electron microscopy revealed glial fibrillary acidic protein(GFAP) expression and pericytoplasmic basal lamina in the tumor cells.
- A Morphologic Study on the Bile Duct Changes Induced by Common Bile Duct Ligation in Rats.
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Jin Young Jeong, Dae Young Kang, Seung Moo Noh
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Korean J Pathol. 1993;27(6):618-629.
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- In an attempt to elucidate the pathological changes following common bile duct ligation, the present study was undertaken in male Sprague-Dawley rats. Morphologic studies of the livers were performed at 1, 2, 3, 5, 7, 9, 11, 13 and 15 weeks after common bile duct ligation. In an attempt to clarify the relationship between the process of bile duct formation and the nature of primitive cells observable around the primitive biliary structure, light microscopic, immunohistochemical and electron microscopic studies were performed. The results were noted as follows: 1) Light microscopically, proliferation of biliary cells began in the periphery of portal areas and expanded toward hepatic lobules. In severe cases of biliary structure proliferation, hepatocytic cords and classic hepatic lobules were inconspicuous. 2) Immunohistochemically, CK-19 expression was limited to biliary structures in protal areas and proliferated biliary epithelial cells. In the serial sections of paraffin block, proliferated intrahepatic biliary structures were associated with those of portal areas. Some oval cells in the ductular hepatocytes were stained for both CK-19 and MNF 116. 3) Ultrastructurally, the proliferated biliary epithelial cells divided into three patterns: absence of lumen, formation of incomplete lumen, and formation of complete lumen. Furthermore these patterns had spectral continuity of maturation in their structures.
4) In some biliary structures, individual biliary cells pushed the basement membrane toward neighboring tissue with accompanying destruction of basement membranes, patterns of budding. Sometimes these cells and hepatocytes comprised the same lumen. In summary, the results obtained by the present study indicate that proliferated biliary structures may be derived from the preexisting intralobular or portal biliary system.
- A Pathological Study of Phenol Induced Hepatic and Gastrointestinal Lesions.
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Dae Young Kang
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Korean J Pathol. 1993;27(6):561-572.
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- In an attempt to elucidate the pathological effects of phenol, the present study was undertaken in male Sprague-Dawley rats. The control group of animals was fed a basal diet, and potable underground water. The experimental group of animals was fed a basal diet and potable underground water containing 30ppm, 60ppm, and 1% phenol with once a week administration of dimethylnitrosamine(DMN) 10 mg/kg I.P. Each group of animals was sacrificed on the 3rd, 6th, and 9th month. The liver and gastrointestinal tract were examined light microscopically, along with transmission electron microscopic studies of the liver and scanning electron microscopic studies of the gastric mucosa.
The results were as follows: 1) In the acute phenol intoxicated group, the liver showed fatty changes in the hepatocytes with mitochondrial membrane destruction and myelin figure formation. 2) In the chronic phenol intoxicated group, fatty changes in the liver were observed.
In addition, there was chronic inflammation in the gastrointestinal tract, with gastric mucosal erosion and central necrosis of the hepatic lobules, especially in the high phenol contaminated water treated group. 3) As a result of the examination under the light microscope, the DMN treated group showed hyperplastic nodules and liver cell dysplasia, the degree of which was proportional to the duration of the experiment, and was more severe in the DMN + phenol treated group. 4) As a result of the examination under the electron microscope, fatty changes in the liver, pleomorphism of the mitochondria and loss or shortness of bile canalicular microvilli in the DMN + phenol treated group were more severe than in the group treated only with DMN. In summary, the results obtained by the present study indicate chronic highly concentrated phenol intoxication induce liver cell necrosis and chronic inflammatory with a hepatotoxin such as DMN.
- A Morphologic Study of the Structural Changes of Normal Aging Facial Skin.
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Joong Won Song, Dae Young Kang
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Korean J Pathol. 1993;27(4):349-361.
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- In an attempt to elucidate the morphologic changes of normal aging skin, the present study was undertaken in human facial and chest well skin of individuals aged from 4 months to 76 years old. Biopsied skin was studied with light microscope, scanning electron microscope, and transmission electron microscope, using both conventional and tannic acid staining. The morphologic changes in the skin were noted as follow: 1. Structurally, the aged epidermis gradually became somewhat thinner, with flattening of the dermoepidermal interface. The number of melanocytes also decreased. 2.
Abnormalities of elastic fibers such as loss of oxytalan fibers were observed from age 30. It was the initial sign of the aging process of elastic fibers, followed by abnormal changes in elaunin and mature elastic fibers. The degree of facial skin abnormality was rather more severe than that of the chest wall skin. 3. In individuals more than 50 years old, the age related changes in mature elastic fibers were more severe. Transmission electron microscopically, the electron density in elastin was irregular. The elastic fibers also showed pores and irregular splitting with fragmentation. Fine granular materials were scattered near the elastin. 4. Scanning electron microscopically, the elastic fibers in young adult skin showd ribbon-like fibers aligned in the same direction. They were either cylindrical or elliptical, having smooth surface. In old skin, the elastic fibers ran in various directions, forming complicated networks. These were larger, more elliptical and more branched than those in young adult skin. In summary, histologic changes of aging are much more prominent in sun-exposed skin(facial skin) than in sun protected skin(chest wall skin). A completely different spectrum of elastic fiber abnormalities was found in individuals more than 30 years old. The result indicates that elastic fiber abnormalities are related to aging skin.
- Flow Cytometric DNA Analysis of Prostate Adenocarcinoma :Correlation with histologic grade and DNA ploidy.
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Hong Ki Lee, Kwang Sun Suh, Dae Young Kang, Jong Woo Park
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Korean J Pathol. 1993;27(1):40-49.
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- Nuclear DNA content of 32 cases of prostate adenocarcinoma diagnosed 1986-1991 was determined by flow cytometry, with the use of paraffin-embedded archival tissue. The present study was done to define the relationship between clinical stage, histopathological grade, and DNA ploidy. Aneuploidy was found in 10(31.3%) cases including 7 cases of near-tetraploidy. Among diploid tumors, 36.4% were localized disease(stage A and B), 13.6% were characterized by invasion outside the prostate(stage C), and 50.0% showed distant metastasis(stage D). Among aneuploid tumors, 10.0% were stage B, 50.0% stage C, and 40.0% stage D. The degree of glandular differentiation was characterized by the Gleason score and the percentage of sampled tissue involved by carcinoma was graded by Dhom's method. Apparent correlation was found between Gleason grade and Dhom grade(P<0.05). All 13 tumors with a Gleason grade I(score of 2 to 5) were diploid. Four of 9 tumors with a Gleason grade II(score of 6 to 7) were aneuploid(near-tetraploidy 33.3%, aneuploidy 11.1%) and 60.0%, of tumors with a Gleason grade III(score of 8 to 10) were aneuploid(near-tetraploidy 40.0%, aneuploidy 20%). The percentage of aneuploid cases increased with advanced clinical stage, but the relationship between aneuploidy versus clinical stage was not significant.
However, it can be concluded that DNA ploidy correlates well with Gleason grade(p<0.05), which may have predictive prognostic value for prostate adeno-carcinomas.
- Atypical Mesoblastic Nephroma: Report of a case.
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Jin Man Kim, Dong Wook Kang, Seung Ki Min, Kwang Sun Suh, Dae Young Kang
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Korean J Pathol. 1991;25(6):601-606.
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- Congenital mesoblastic nephroma(CMN) is an important differential diagnosis of a renal mass occurring in the newborn or in early childhood. It was first described by Bolande as a separate disease entity distinct form Wilms' tumor. In 1974, Beckwith has predicted that this tumor has a pathologic spectrum with classic congenital mesoblastic nephroma at one extreme, unequivocally mallignant spindle cell sarcomas at the other, and intermediate "gray zone" lesions of indeterminate biologic significanse. In 1986, Joshi has described "atypical mesoblastic nephroma" as a potentially aggressive variant of CMN, which shows atypical gross and microscopic features such as hemorrhage, necrosis, high cellularity, and mitotic index. We report of a case of atypical mesoblastic nephroma presenting in a 38 days-old male infant. Grossly, the tumor involved the upper and midportion of the left kidney. On section, the cut surface was fleshy, grayish-white, and homogeneous. Microscopically, the tumorshowed high degree of cellularity and arrangement of fusiform cells in sheets and vague interlacing bundles.
The individual tumor cells showed fusiform to oval nuclei, indistinct scanty pale-eosinophilic cytoplasm and many mitotic figures.
- Immunopathologic Study and Clinical Correlation of Non-Hodgkin's Lymphoma.
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Mi Seon Lee, Jin Man Kim, Kwang Sun Suh, Dae Young Kang
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Korean J Pathol. 1991;25(5):407-417.
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Abstract
- In Korea, the proportion of B-cell and T-cell lymphomas has not yet been clearly estimated. In the present study, we analysed clinicopathologic and immunophenotypic findings in 60 cases of non-Hodgkin's lymphomas(NHL) and in 17 cases of polymorphic reticulosis. Immunohistochemical studies for monoclonal antibodies, such as MB2, UCHL-1, Kappa/Lambda light chains, and IgG/IgM/IgD heavy chains were performed on formaldehyde-fixed paraffin embedded tissue sections. Among 60 cases of NHL, 28 cases(46.7%) expressed B-cell markers, 29 cases(48.3%) T-cell markers, and 3 cases(5.0%) lacked detectable markers, whereas 16 of 17 cases(94.2%) of polymorphic reticulosis reacted with T-cell markers. The mean survival of the 16 cases of T-cell lymphoma group was shorter than that of the lymphoma group positive for B-cell markers.
- Neuroendocrine Carcinoma of the Gallbladder Arising as Double Tumor.
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Dae Hyun Baek, Seong Ki Min, Jin Man Kim, Kwang Sun Suh, Dae Young Kang
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Korean J Pathol. 1990;24(3):299-303.
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- Pleomorphic (undifferentated) carcinoma is a rare histologic type of carcinomas of the gallbladder and an atypical carcinoid is thought to be an intermediated type between carcinoid tumor and small cell carcinoma. Dense core "neurosecretory" granules can be found in the above mentioned tumors. We experienced a case of a double tumor of the gallbladder in a 51-year old male patient. Grossly, a large solid mass, about 5.0 cm in diameter, was found in the fundic portion and the neck portion also had a small 1.5 cm-sized polypoid mass. Microscopically, these lesions had features of pleomorphic carcinoma and atypical carcinoid, respectively. Immunohistochemically, they manifested reactivity for neuron specific enolase. Ultrastructural study revealed neurosecretory granules in the cytoplasms of tumor cells of the fundic and neck masses. Although light microscopic features of these tumor masses are quite different, we consider that these tumors represent a spectrum of neuroendocrine differentiation.
- Endodermal Sinus Tumor of the Orbit.
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Dae Hyun Back, Jin Man Kim, Kwang Sun Suh, Kyu Sang Song, Choong Sik Lee, Dae Young Kang
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Korean J Pathol. 1989;23(3):392-395.
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- An endodermal sinus tumor is a malignant germ cell tumor that usually arises in the gonads, but on rare occasion occurs in extragonadal locations. Our case was that of a 3 year old girl who complained of a rapid growing orbital mass. On histologic examination it revealed the typical picture of an endodermal sinus tumor and it also disclosed a positive reaction for alphafetoprotein using an immunoperoxidase technique. An orbital exenteration was performed followed by chemotheraphy, but the patient died 5 months after the onset of the disease.
- Malignant Fibrous Histiocytoma of the Heart: A case report.
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Mi Seon Lee, Kyu Sang Song, Kwang Sun Suh, Dae Young Kang, Young Lee
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Korean J Pathol. 1988;22(2):138-144.
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- A case of a 58-year-old man with malignant fibrous histiocytoma (MFH) of the right ventricle is reported light and electron microscopically. This is the first case of MFH of the heart in the Korean literature. A tendency for malignant fibrous histiocytoma of the heart to occur in the left atrium of young women is suggested; this sarcoma's usual location is in the soft tissue of elderly men. The tumor consisted of spindle cells arranged in a focal storiform patterns, clusters or sheets of histocyte-like cells, benign and malignant giant cells, inflammatory cells, scattered mitotic figures and anaplasia of stromal cells. In ultrastructure the constituent of cells of the tumor are primitive mesenchymal cells, histiocytoid cells and fibroblast like cells including giant cells.
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