Journal of Pathology and Translational Medicine

Dong Geun Lee

52 Articles

Fine Needle Aspiration Cytology of Gastric Glomus Tumor: A Case Report.: Dong Geun Lee, Kyu Yun Jang, Myoung Ja Chung, Woo Sung Moon, Myoung Jae Kang, Ho Sung Park; Korean J Pathol. 2010;44(4):448-452.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.4.448

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Glomus tumors of the stomach are rare and are usually found as a solitary, intramural lesion. Here, we report a case of a gastric glomus tumor in a 60-year-old woman diagnosed by endoscopic ultrasound-guided fine-needle aspiration cytology. Endoscopic ultrasound revealed a 4 x 3 cm-sized, round, isoechoic mass at the fourth layer of the gastric wall. Smears revealed cohesive clusters of small, uniform, round to polygonal cells with scant cytoplasm and round, hyperchromatic nuclei with homogeneous chromatin. Immunocytochemistry by liquid-based cytology was positive for smooth muscle actin. The cytologic diagnosis of a glomus tumor was confirmed by a specimen from the laparoscopic resection. Although the cytologic features of glomus tumors are quite distinctive, an immunocytochemical stain from a liquid-based cytology preparation can further help to ascertain the diagnosis.

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Glomus Tumor of the Stomach: A Systematic Review and Illustrative Case Report
Andrea Pansa, Laura Samà, Laura Ruspi, Federico Sicoli, Ferdinando Carlo Maria Cananzi, Vittorio Quagliuolo
Digestive Diseases.2023; 41(1): 17. CrossRef
Cytologic analysis of a glomus tumor in the left second toe: Case report
Jay Hwang, Susan McDowell, Bradley Cole, Aaron Huber, Maria Cecilia D. Reyes
Diagnostic Cytopathology.2022;[Epub] CrossRef

Quality Control Program for Fresh Frozen Tissue and Its Results of Chonbuk National University Hospital National Biobank of Korea.: Shin Young Park, Hyun Ah Baek, Hyoung Jong Kwak, Sang Hyun Hong, Ho Sung Park, Kyu Yun Jang, Woo Sung Moon, Myoung Jae Kang, Dong Geun Lee, Myoung Ja Chung; Korean J Pathol. 2010;44(3):295-301.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.3.295

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Abstract PDF

BACKGROUND
Molecular tools for tissue profiling generally require collection of fresh frozen tissues (FFT) as sources of high-quality DNA and RNA. Nowadays, researchers carry out large-scale, multi-center studies and they request inter-institutional minimal intrinsic bias, some fundamental similarities, and the same standardized and validated procedures.
METHODS
This study reports standardized quality control procedure for fresh frozen tissue of the National Biobank of Korea.
RESULTS
The main procedures for quality control for FFT are as follows: records related to sample collection such as labeling of samples, transport temperature, lag time from excision of tissue to freezing, and sample size were reviewed for all fresh frozen samples. The stability of RNA and DNA in fresh frozen tissue was evaluated for 3% of collected samples and purity was assessed (ratio of the absorbance at 260 and 280 nm) as was integrity (agarose gel electrophoresis). Stained hematoxylin and eosin sections were reviewed by a pathologist to confirm the diagnosis and to assess how representative the frozen sample was.
CONCLUSIONS
We introduced that the quality-control criteria for fresh frozen tissue of the NBK. We expect that this study contributes to standardization of collection, storage, and quality control of fresh frozen tissue.

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Influence of Cold Ischemia Time and Storage Period on DNA Quality and Biomarker Research in Biobanked Colorectal Cancer Tissues
Min Gyoung Pak, Mee Sook Roh
Kosin Medical Journal.2020; 35(1): 26. CrossRef

The Expressions of Nerve Growth Factor and Its Receptor p75NGFR in Hepatocellular Carcinoma: Their Relation with the Clinicopathologic Factors.: Woo Sung Moon, Kyu Yun Jang, Myoung Ja Chung, Myoung Jae Kang, Dong Geun Lee, Ho Lee, Ho Sung Park; Korean J Pathol. 2009;43(2):145-151.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.2.145

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Abstract PDF

BACKGROUND
Nerve growth factor (NGF) has been suggested to participate in tumor progression and it can interact with its receptor p75NGFR. In the present study, we investigated the expressions of NGF and p75NGFR in hepatocellular carcinoma (HCC).
METHODS
We performed immunohistochemistry for NGF, p75NGFR and PCNA in 45 cases of HCCs, and examined the relationships between the clinicopathologic factors and the immunohistochemical results.
RESULTS
NGF was detected in 84.4% (38/45) of the tumor cells and in 64.4% (29/45) of the non-tumorous hepatocytes. Furthermore, a NGF expression was present in 28.9% (13/45) of the endothelial cells in the HCCs, but in 80% (36/45) of the endothelial cells in the non-tumor liver tissue. The tumor cells were negative for p75NGFR in all the HCCs. Although a p75NGFR expression was present in all the nerve fibers in the non-tumor liver tissues, it was markedly reduced (42.2%; 19/45) in the HCCs and a p75NGFR expression was observed at the sinusoids or around the large vessels. The HCCs expressing NGF, either in the tumor cells or the endothelial cells, showed a larger size than those HCCs that didn't express NGF. The NGF positive tumors showed a tendency toward a higher PCNA-labeling index than did the negative tumors.
CONCLUSIONS
The changed localization of the NGF expression and the decreased expression of p75NGFR are associated with hepatic carcinogenesis. We suggest that a NGF expression may contribute to the progression of HCC.

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Expression of nerve growth factor and heme oxygenase-1 predict poor survival of breast carcinoma patients
Sang Jae Noh, Jun Sang Bae, Urangoo Jamiyandorj, Ho Sung Park, Keun Sang Kwon, Sung Hoo Jung, Hyun Jo Youn, Ho Lee, Byung-Hyun Park, Myoung Ja Chung, Woo Sung Moon, Myoung Jae Kang, Kyu Yun Jang
BMC Cancer.2013;[Epub] CrossRef

Expression of Claudin-1, p53 and E-cadherin in Pseudoepitheliomatous Hyperplasia and Squamous Cell Carcinoma of the Head and Neck.: Keum Ha Choi, Jae Hong Lim, Ju Hyung Lee, Keun Sang Kwon, Ho Lee, Ho Sung Park, Myoung Ja Chung, Woo Sung Moon, Jae Soon Eun, Dong Geun Lee, Kyu Yun Jang; Korean J Pathol. 2008;42(5):287-293.

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Abstract PDF: BACKGROUND
Pseudoepitheliomatous hyperplasia (PEH) is a reactive proliferation of surface epithelium and can be confused with invasive squamous cell carcinoma (SCC) in head and neck biopsy specimens. To distinguish PEH from invasive SCC, immunohistochemical staining for claudin-1, E-cadherin and p53 was performed. METHODS: Eighteen cases of PEH and 29 invasive SCC from head and neck lesions were immunostained and examined. RESULTS: The invasive SCC showed increased staining of claudin-1 (p<0.001) and p53 (p<0.001) and decreased staining of E-cadherin (p=0.005) compared to the PEH specimens. The combined score calculated by adding the positive sum of claudin-1 and p53 and subtracting E-cadherin was useful for the differentiation of SCC from PEH (89.7% sensitivity and 88.9% specificity, p<0.001). CONCLUSION: The combined immunostaining for claudin-1, p53 and E-cadherin may help differentiate PEH from invasive SCC. The results of this study suggest that the increased expression of claudin-1 and p53 and the decreased expression of E-cadherin maybe markers for the aggressive growth of invasive SCC.

Correlation of the Nuclear beta-catenin Expression with the Clinicopathological Parameters of Hepatocellular Carcinoma.: Hyoung Jong Kwak, Ha Na Choi, Sung Ho Hwang, Keum Ha Choi, Ho Sung Park, Kyu Yun Jang, Myoung Ja Chung, Myoung Jae Kang, Dong Geun Lee, Woo Sung Moon; Korean J Pathol. 2008;42(4):208-214.

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Abstract PDF: BACKGROUND
Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the human liver. However, the molecular changes and mechanisms that regulate the development and progression of HCC remain unclear. Beta-catenin is known as a multi-functional protein that acts as a regulator of the cadherin-mediated cell-cell adhesion system and also in the Wingless/Wnt signal transduction pathway. The aim of this study was to investigate the expression of beta-catenin and its possible role in HCC.
METHODS
We investigated the expression of beta-catenin, Ki-67, TP53, alpha-smooth muscle actin and CD34 by performing immunohistochemical staining for 61 specimens of HCC and their adjacent non-tumorous tissue. We also examined the relationship between the nuclear expression of beta-catenin and the clinicopathologic parameters.
RESULTS
The altered expression of beta-catenin was not detected in the nontumorous liver tissue. The nuclear expression of beta-catenin was observed in approximately 16% (10/61) of the HCC specimens. Double immunohistochemical staining for beta-catenin and E-cadherin showed a close relationship between nuclear translocation of beta-catenin and the loss of the membranous E-cadherin expression. Significant correlation was found between the nuclear translocation of beta-catenin and the tumor size, tumor necrosis and the presence of microvessel invasion and intrahepatic metastasis (p<0.05).
CONCLUSIONS
This data indicates that nuclear translocation of beta-catenin could play a role in the growth and progression of HCC.

Actinomycosis of the Penile Shaft Coexisting with Fibrous Pseudotumor of the Testis.: Eun Jung Cha, Kyu Yun Jang, Ho Sung Park, Jong Kwan Park, Chang Seop Lee, Myoung Ja Chung, Woo Sung Moon, Dong Geun Lee, Myoung Jae Kang; Korean J Pathol. 2008;42(1):50-53.

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Abstract PDF: Here, we present an uncommon case of the penile shaft actinomycosis with coexisting fibrous pseudotumors of the testis. A 37-year-old, circumcised man presented with one penile and eight scrotal masses. The penile mass having a healed surface ulceration was located at the right side of the penile shaft. It was relatively circumscribed without a fibrous capsule. The cut surface showed a yellow-brown color with central focal necrosis. The scrotal tumors were circumscribed, whorled, white masses 0.3-2.0 cm in diameters, and were attached to the tunica vaginalis and tunica albuginea. Microscopically, the penile mass showed active inflammatory changes containing actinomyces displaying characteristic sulfur granules. Testicular masses were fibrous pseudotumors composed of bland spindle and stellate cells lying in dense collagenous stroma. Actinomycosis of the penis has been reported to occur at the corona of the uncircumcised penis associated with pilonidal sinus. The present case was not associated with pilonidal sinus and, unusually, displayed co-existence with fibrous pseudotumors of the testis.

Synergistic Apoptotic Effect of Combination Treatment with Troglitazone and COX-2 Inhibitor in Glioma Cells.: Kyung Ryoul Kim, Min Young Park, Ho Sung Park, Kyu Yun Jang, Woo Sung Moon, Dong Geun Lee, Myoung Jae Kang; Korean J Pathol. 2007;41(1):1-6.

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Abstract PDF: BACKGROUND
The use of troglitazone (a PPARgamma ligand) and COX-2 inhibitor have been intensively studied for inhibition of tumor growth in cancer treatment, but the anti-tumor effect with a combination of these agents for cancer has not yet been studied. The aim of this study was to determine if low concentrations of troglitazone with COX-2 inhibitor in combination would cause significant cytotoxicity in glioma cells.
METHODS
The effects of co-treatment with troglitazone and COX-2 inhibitor on cell growth and apoptosis were assessed by use of trypan blue exclusion and a DNA fragmentation assay. A western blot was used to analyze the apoptotic signaling for the expression of bcl-2, bax, PARP and p21 proteins.
RESULTS
A low dose of troglitazone (5micrometer) and COX-2 inhibitor (5micrometer) strongly enhanced the cell growth inhibition and apoptosis in glioma cells when compared to a low dose of each drug alone. Western blotting analysis showed a decreased expression of bcl-2 and PARP proteins. In contrast, the bax protein level was increased.
CONCLUSIONS
The combination of troglitazone and COX-2 inhibitor in a low dose elicits synergistic cytotoxicity in glioma cells. Our study also demonstrates that down regulation of bcl-2, fragmentation of PARP protein and increased expression of bax protein were accompanied by co-treatment with troglitazone and the COX-2 inhibitor.

PPARgamma Ligand-Induced Decrease of in vivo Tumor Growth Accompanied by Increased Cytolytic Activity of Splenocytes.: Kyu Yun Jang, Ki Hoon Yu, Hak Yong Lee, Kyung Ryoul Kim, Ha Na Choi, Eun Jung Cha, Ho Sung Park, Woo Sung Moon, Myoung Jae Kang, Dong Geun Lee; Korean J Pathol. 2007;41(1):7-14.

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Abstract PDF: BACKGROUND
Recent studies have proposed the use of peroxisome proliferator activated receptor-gamma (PPARgamma) ligands as new chemotherapeutic agents for human malignant tumors. However the in vivo mechanism of PPARgamma ligands on cellular toxicity is not clear. Therefore we examined the anti-tumor effects of the PPARgamma ligand, rosiglitazone (ROS), in animal models.
METHODS
To evaluate the effect of RSO on splenocytes, an in vitro and in vivo study was performed. Cytolytic activity was measured by use of a 51Cr release assay. The splenic natural killer (NK) cell population and effector-target conjugation were measured by flow cytometric analysis.
RESULTS
In 9L glioma bearing rats, 30 mg/kg/d of ROS treatment induced a significant decrease of subcutaneous tumor growth accompanied by an increased cytolytic activity of splenocytes and of the splenic NKR-P1bright/CD3- NK cell population. In normal rats, systemic administration of ROS also increased the cytolytic activity of splenocytes, the splenic NK cell population, and effector-target conjugation. Moreover, we found that a concentration of 20micrometer ROS caused an increase in the cytolytic activity of splenocytes, and a concentration of 50micrometer ROS increased effector-target conjugation in vitro.
CONCLUSIONS
These results suggest that increased splenic cytolytic activity and NK cell population may contribute to the anti-tumor effects of PPARgamma ligands in vivo. However, the roles of NK cells in the PPARgamma ligand-induced anti-tumor activity should be further investigated.

Expression of Epidermal Growth Factor Receptor Related Protein in Gallbladder Cancer: An Association with p53 Mutation.: Ho Sung Park, Kyu Yun Jang, Kyung Ryoul Kim, Hak Yong Lee, Andrzej S Tarnawski, Adhip P N Majumdar, Myoung Jae Kang, Dong Geun Lee, Woo Sung Moon; Korean J Pathol. 2005;39(6):385-390.

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Abstract PDF: BACKGROUND
It has been well demonstrated that the overexpression of epidermal growth factor receptor (EGFR) is associated with numerous gastrointestinal malignancies, including gallbladder carcinoma. However, the cellular events that regulate EGFR in cancer cells have not been fully elucidated. A novel negative regulator of EGFR that is referred to as EGFR related protein (ERRP) has recently been identified. The aim of this study was to investigate the expression and localization of ERRP in gallbladder carcinoma and to examine a possible role for ERRP.
METHODS
We examined the immunohistochemical expressions of ERRP, p53 and proliferating cell nuclear antigen labeling index (PCNA-LI) in formalin-fixed, paraffinembedded specimens of 43 cases of gallbladder carcinoma, 7 cases of adenoma and 3 cases of dysplasia.
RESULTS
In the normal mucosa, ERRP immunoreactivity was positive in over 64% of specimens. In contrast, the ERRP staining was positive in only 46% of the cancer specimens. The expression of ERRP in cancer cells was inversely correlated with tumor cell proliferation. The loss of ERRP expression correlated with the p53 overexpression.
CONCLUSIONS
Our data indicate that the down-regulation or loss of ERRP could play an important role in the progression of gallbladder carcinoma. The inverse relationship between the ERRP expression and PCNA-LI suggests that ERRP may play a role in the inhibition of tumor cell proliferation in gallbladder cancer.

Expression of Vascular Endothelial Growth Factor-C in Breast Carcinoma.: Myoung Ja Chung, Sun Ho Yang, Kyu Yun Jang, Woo Sung Moon, Myoung Jae Kang, Dong Geun Lee; Korean J Pathol. 2005;39(6):401-405.

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Abstract PDF: BACKGROUND
Vascular endothelial growth factor-C (VEGF-C) is a novel growth factor that regulates lymphangiogenesis and/or angiogenesis via binding to the vascular endothelial growth factor receptor-3 (VEGFR-3) or VEGFR-2. Recent studies have suggested that VEGF-C may play a role in lymph node metastasis. This study was conducted to examine whether the expression of VEGF-C is associated with the clinicopathologic parameters, and especially lymph node metastasis, of invasive ductal carcinoma.
METHODS
Immunohistochemical staining was performed for VEGF-C and CD31 in the surgically resected specimens from 83 patients with invasive breast carcinoma.
RESULTS
Of the 83 breast carcinomas, 61 (74%) cases showed cytoplasmic VEGF-C imunoreactivity. VEGF-C expression was associated with lymph node metastasis (p=0.03), but it did not correlate with tumor size, the histologic grade, and the presence of estrogen receptor or progesteron receptor. The mean microvessel density in the cases without VEGF-C expression was 51.9+/-30.1 and it was 72.9+/-33.0 in the cases with 2+ expression for VEGF-C (p=0.07).
CONCLUSIONS
This study suggests that VEGF-C expression may have an association with lymph node metastasis in the patients with breast carcinoma.

Expression of Vascular Endothelial Growth Factors A,C and D in Gastric Adenocarcinoma.: Myoung Ja Chung, Jin Wook Lee, Ki Hoon Yu, Doo Hyun Yang, Kyu Yun Jang, Woo Sung Moon, Myoung Jae Kang, Dong Geun Lee; Korean J Pathol. 2005;39(2):99-105.

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Abstract PDF: BACKGROUND
Vascular endothelial growth factor (VEGF)-C and VEGF-D are novel growth factors that regulate lymphatic vessel growth. This study was designed to examine whether the expression of three VEGF family members, VEGF-A, VEGF-C and VEGF-D are associated with the clinicopathologic parameters, especially with lymph node metastasis, in advanced gastric carcinomas.
METHODS
Immunohistochemical staining was performed for VEGF-A, VEGF-C, and VEGF-D in the surgically resected specimens from 102 patients with advanced gastric carcinoma. The mRNA expressions of the three VEGF family members were assessed in 16 cases of tumor tissues and their corresponding non-neoplastic tissues.
RESULTS
Of the 102 gastric carcinomas, 74 (73%), 82 (80%), and 34 (33%) cases showed cytoplasmic immunoreactivity for VEGF-A, VEGF-C and VEGF-D, respectively. Both VEGF-A and VEGF-C expressions were associated with lymphatic invasion and lymph node metastasis (p<0.05), but the VEGF-D expression was not associated with them (p>0.05). In the tumor tissue, VEGF-C mRNA expression was greater, while VEGF-D mRNA expression was lower than in the nonneoplatic tissue adjacent to the tumor.
CONCLUSIONS
VEGF-A and VEGF-C may play important roles for the lymphatic spread of gastric carcinoma. We suggest that neutralizing both VEGF-A and VEGF-C may be reguired to block lymph node metastasis.

Inflammatory Myofibroblastic Tumor of the Breast: A Case Report.: Myoung Ja Chung, So Yeong Oh, Kyu Yun Jang, Woo Sung Moon, Myoung Jae Kang, Dong Geun Lee; Korean J Pathol. 2005;39(1):54-58.

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Abstract PDF: Inflammatory myofibroblastic tumor (IMT) is characterized by a clonal proliferation of myofibroblasic spindle cells, and this is accompanied by a lymphoplasmacytic infiltration. In the majority of cases, this disease has occurred in the lungs and only 9 cases of IMT in the breast have been previously reported. We report here on an IMT in a 25-year-old-female who presented with a palpable mass in the right breast. Histologically, it was characterized by plump spindle cells admixed with prominent inflammation, that was composed of lymphocytes and plasma cells. Immunohistochemically, the spindle cells were positive for vimentin and -smooth muscle actin.

Granulosa Cell Tumor of the Unilocular Cystic Type: A Case Report.: Kyu Yun Jang, Myoung Ja Chung, Woo Sung Moon, Myoung Jae Kang, Dong Geun Lee; Korean J Pathol. 2004;38(4):284-287.

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Abstract PDF: Unilocular cystic granulosa cell tumors (UCG) are extremely rare. Due to the relatively small mass of the tumor available for histologic examination, diagnosis of UCG is not easy. Here we present a case of UCG in a 54-year old female. A 12x10 cm unilocular cystic mass was identified in the right ovary. The tumor was thin-walled and consisted of a single large cavity with a smooth internal surface. In most areas there were no cells lining the cyst, however, in focal areas the unilocular cyst was lined by one or more layers of uniform granulosa cells, forming Call-Exner bodies. A diagnosis of UCG was made after multiple sections were examined. A careful histologic examination is required for the correct diagnosis of UCG.

Intraocular Ossification: A Case Report.: Ho Sung Park, Tae Shik Kong, Kyu Yun Jang, Myoung Ja Chung, Woo Sung Moon, Dong Geun Lee, Myoung Jae Kang; Korean J Pathol. 2004;38(3):188-190.

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Abstract PDF: Heterotopic bone formation in the eyeball is a rare finding. Some etiologic factors, such as trauma, chronic inflammation, and long-standing retinal detachment have been associated with the onset of intraocular ossification. We report here on a case of a 21-year-old woman with a history of blunt trauma fifteen years ago, who complained of right eye blindness. When the right eyeball eviceration was done, a hard, grayish mass was found. On histopathologic examination, the mass showed lamellar bone with fatty marrow and hyalinized tissue with dystrophic calcification. We diagnosed her case as intraocular ossification.

Lymph Node Infarction After Fine-Needle Aspiration.: Ho Sung Park, Kyu Yun Jang, Myoung Ja Chung, Woo Sung Moon, Dong Geun Lee, Myoung Jae Kang; Korean J Pathol. 2004;38(3):204-207.

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Abstract PDF: Histologic alterations of lymph nodes following fine-needle aspiration have not been well described. Only two cases of lymph node infarction following fine-needle aspiration have currently been reported. We report here on a case of near total infarction of a lymph node that was detected 16 days after fine-needle aspiration in a 74-year old man. A fine-needle aspiration smear of the right inguinal lymph node showed scattered and clustered cells including lymphocytes, plasma cells, neutrophils that were seen as a reactive nodal hyperplasia in the clean background. There were no malignant cells, granulomas or necrotic debris. In the incisional biopsy of the same lymph node, the sections revealed a thin rim of viable lymphocytes, granular tissue was noted peripherally and extensive necrosis associated with vascular thrombi was noted centrally. There was no evidence of malignancy or granulomatous inflammation.

Abdominal Endometriosis Diagnosed by Fine Needle Aspiration Cytology: A Report of Two Cases.: Myoung Ja Chung, Yeon Jun Jeong, Ho Myong Hwang, Kyu Yoon Jang, Woo Sung Moon, Myoung Jae Kang, Dong Geun Lee; Korean J Cytopathol. 2004;15(1):70-73.

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Abstract PDF: The incidence of endometriosis in post-operative abdominal scars is rare. We describe two cases of abdominal endometriosis diagnosed by fine needle aspiration (FNA). Both patients presented with subcutaneous masses at previous cesarean section scars with cyclic symptoms of pain. The cytologic smears were cellular and comprised two distinct cell populations consisting of epithelial and stromal components. An epithelial component consisted of flat sheets of polygonal cells and the second stromal component showed crowded clusters of spindle cells or isolated single cells. Hemosiderin-laden macrophages were found in the background. FNA offers a safe and effective tool for diagnosis of abdominal wall endometriosis.

Primary Squamous Cell Carcinoma of the Ovary: A Case Report.: Ho Sung Park, Kyu Yun Jang, Myoung Ja Chung, Dong Geun Lee, Myoung Jae Kang; Korean J Pathol. 2003;37(3):218-220.

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Abstract PDF: Most cases of primary squamous cell carcinoma of the ovary are associated with mature teratoma or Brenner tumor, and a few cases are related to endometriosis of the ovary. But a few cases of ovarian primary squamous cell carcinoma have occurred without clear associated etiology. Although some of them are concurred with cervical carcinoma in situ, they have not shown clear associations with the ovarian primary squamous cell carcinoma. We report a case of primary squamous cell carcinoma of the ovary appearing in pure form. A left ovarian mass was detected in a 43-year-old woman. A total hysterectomy and bilateral adnexectomy with regional lymph node dissection were performed. Histologically, the tumor was predominantly composed of polygonal tumor cells with keratinization and intercellular bridge, dyskeratotic cells, necrotic cell debris, and inflammatory cells. Also, metastasis to paraaortic lymph node was detected.

Expression of Transforming Growth Factor-beta and Its Receptors during Acetic Acid-induced Duodenal Ulcer Healing in Rats.: Kyu Yun Jang, Han Sang Yoon, Ki Hoon Yu, Myung Ja Chung, Dong Geun Lee, Jae Kang Myoung; Korean J Pathol. 2003;37(2):108-114.

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Abstract PDF: BACKGROUND
Many works have been written about the transforming growth factor-beta 1 (TGF-beta1) which is closely associated with fibrosis in the inflammatory conditions of different organs. TGF-beta1 exerts its biological effects by interacting with specific cell surface receptors, namely, transforming growth factor-beta receptor type I and II (TGFbetaRI and TGFbetaRII).
METHODS
To investigate the temporal expressions and localizations of TGF-beta1, TGFRbetaI, and TGFbetaRII in acetic acid-induced duodenal ulcerated tissues, we performed in situ hybridization and immunohistochemical techniques.
RESULTS
Under in situ hybridization, TGF-beta1, TGFbetaRI, and TGFbetaRII mRNA signals increased in the experimental groups (1, 3, 7, and 14 day groups) compared to those of the control group. The signals on day 14 decreased slightly compared to those of days 1, 3, and 7, but they were higher than those of the control group. Under immunohistochemical study, TGF-beta1, TGFbetaRI, and TGFbetaRII were localized in the mucosal epithelial cells and in the macrophages, vascular endothelial cells, and fibroblasts of the lamina propria and granulation tissue. As in the case of the in situ hybridization, it revealed that the expression of three proteins increased in the experimental groups compared to that of the control group. The expression on day 14 decreased compared to those of days 1, 3, and 7, but it was more intense than that of the control group.
CONCLUSIONS
This study suggests that TGF-beta1, TGFbetaRI, and TGFbetaRII contribute to the early stage healing of duodenal ulcer.

The Expression of Transforming Growth Factor-1 and Its Signaling Receptors in Human Colorectal Carcinoma.: Gyeong Seon Kim, Joo Heon Kim, Woo Sung Moon, Myoung Ja Chung, Dong Geun Lee, Myoung Jae Kang; Korean J Pathol. 2001;35(2):115-122.

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Abstract PDF: BACKGROUND
Resistance to the potent growth inhibitory effects of TGF- (transforming growth factor-) is a characteristic of many malignancies. TGF- insensitivity has been attributed to alterations in the number and function of the TGF- receptors as well as disturbances of downstream signal transduction. The aim of this study was to examine the expression of TGF-1 and its receptors in human colorectal cancer tissue and determine its relationship with cancer growth and with prognostic factors.
METHODS
Immunohistochemical staining of TGF-1, TGF-RI, and TGF-RII was performed on 20 human colorectal adenomas, 30 carcinomas and 10 normal mucosas as a control.
RESULTS
The staining indices of TGF-1, TGF-RI, and TGF-RII increased in adenomas and carcinomas compared with normal mucosas and adenomas, respectively. In adenomas the staining index of TGF-1 significantly increased with the severity of atypism. The staining index of TGF-RII increased in the carcinomas in the right colon and rectum, compared with those in the left colon.
CONCLUSION
The enhanced expression of TGF-1, TGF-RI and II in the colorectal carcinoma suggests an important role of colorectal carcinogenesis and tumor progression.

Gastric Collision Tumor (Adenocarcinoma and Neuro-endocrine Carcinoma): A Report of Two Cases.: Ho Sung Park, Ja Myoung Chung, Woo Sung Moon, Myoung Jae Kang, Dong Geun Lee; Korean J Pathol. 2001;35(1):76-79.

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Abstract PDF: Concurrence of adenocarcinoma and neuroendocrine carcinoma in the gastrointestinal tract has rarely been observed. We report two cases of gastric collision tumors (adenocarcinoma and neuroendocrine carcinoma) that developed in a 64-year-old man and a 71-year-old man. In both cases, there was a single ulcerative lesion in the stomach. Histologically, the gastric lesions were composed of two discrete lesions: tubular adenocarcinoma at the edge of an ulcer and neuroendocrine carcinoma in the ulcer base. We will discuss collision and composite tumors.

Adenoid Basal Cell Tumor of the Prostate: A case report.: Joo Heon Kim, Woo Sung Moon, Myoung Jae Kang, Dong Geun Lee, Jae Y Ro; Korean J Pathol. 2000;34(7):534-536.

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Abstract PDF: Adenoid basal cell tumor of the prostate is a rare tumorous lesion that can be misdiagnosed as adenocarcinoma of the prostate. The malignant potential of adenoid basal cell tumor remains uncertain due to small number of reported cases. This 66-year-old man presented with symptoms of urinary tract obstruction. Under the impression of benign prostatic hyperplasia, a transurethral resection of the prostate (TURP) was performed. The patient was alive with no evidence of recurrence or metastasis 15 months after TURP. Microscopically, most of the lesions were composed of nodular collections of small nests of basaloid cells with peripheral palisading, and clusters of tumor cells forming cribriform pattern. Multiple areas of basal cell hyperplasia and atypical basal cell hyperpalsia were also observed. The coexistence of basal cell hyperplasia, atypical basal cell hyperpalsia, and adenoid basal cell tumor with cribriform pattern in this case supports a morphologic continuum from the benign hyperplastic lesion to malignant neoplasia.

Multiple Plexiform Schwannomas Associated with Neurofibromatosis Type 2: A case report.: Ho Sung Park, Myoung Ja Chung, Myoung Jae Kang, Dong Geun Lee, Byung Cook Ahn; Korean J Pathol. 2000;34(5):389-392.

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Abstract PDF: Plexiform schwannoma is a rare benign tumor arising from the peripheral nerve sheath and characterized by a multinodular and plexiform growth pattern. This tumor usually arises sporadically. In rare cases, plexiform schwannomas have been associated with neurofibromatosis type 2. Plexiform schwannoma should be differentiated from plexiform neurofibroma, because the latter is pathognomonic tumor of neurofibromatosis type 1 and has a potential of malignant transformation. We report a case of multiple plexiform schwannomas associated with bilateral acoustic neuromas and meningioma.

Heterotopic Prostatic Tissue with Cystic Change in Retrovesical Space: A case report.: Hyun Jin Son, Myoung Jae Kang, Dong Geun Lee; Korean J Pathol. 2000;34(1):93-95.

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Abstract PDF: Heterotopic prostatic tissue has been reported in a variety of sites within and outside the urinary tract. Extra-urethral ectopic prostatic tissue is a distinct entity and may be more common than previously thought. We report a case of heterotopic prostatic tissue in 71-year-old man. Pelvic CT scan showed a well circumscribed cystic mass in the retrovesical space. Grossly, the tumor was 7.5 7.0 2.8 cm and revealed an ovoid unilocular cyst containing grayish amorphous granular materials. The prostatic origin of the tissue was confirmed by immunohistochemical staining for prostate specific antigen.

Fine Needle Aspiration Cytology of Pilomatrixoma: A Report of Five Cases.: Ho Sung Park, Myoung Ja Chung, Myoung Jae Kang, Dong Geun Lee; Korean J Cytopathol. 2000;11(1):53-58.

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Abstract PDF: Pilomatrixoma is a benign tumor which usually occur as a solitary, firm nodule in the head and neck, and upper extremities of young people. This tumor is occasionally encountered during aspiration biopsy of subcutaneous masses, but only a small number of cases are correctly diagnosed prior to excision. We report five cases of pilomatrixoma. Four cases occurred in the neck and one case in the back. The characteristic fine needle aspiration cytologic features are shadow cells and basaloid cells in the background of inflammatory cells, including some multinucleated giant cells. The shadow cells were recognized in all five cases. These cells were pale, anucleated cells with relatively distinct cell borders. May-Gr nbald-Giemsa stain is useful for the identification of shadow cells. The recognition of shadow cells appears to be essential for accurate diagnosis of pilomatrixoma.

Expression of Epidermal Growth Factor Related Peptides, EGF-R, and c-erbB-2 and Their Relationship with the Prognostic Factors in Gastric Carcinoma.: Joo Heon Kim, Jin Wook Lee, Woo Sung Moon, Myoung Jae Kang, Dong Geun Lee; Korean J Pathol. 1999;33(11):1039-1046.

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Abstract PDF: Recent investigations have revealed that autocrine growth factors and their receptors are closely related and play an important role in controlling cancer cell growth. We performed an immunohistochemical study on the expression of epidermal growth factor (EGF), transforming growth factor-alpha (TGF-alpha), epidermal growth factor receptor (EGF-R), c-erbB-2, and PCNA labelling index in 60 cases of human gastric carcinomas. TGF-alpha was detected in 38 cases (63.3%), EGF in 26 cases (43.3%), EGF-R in 44 cases (73.3%), and c-erbB-2 in 18 cases (30%). These growth factors, EGF-R and c-erbB-2, were found more often in advanced gastric cancers. The PCNA labeling index was significantly higher in tumors with the expression of EGF-R or c-erbB-2. Tumors with simultaneous expression of EGF, TGF-alpha, EGF-R and c-erbB-2 was associated with a high PCNA labeling index. A correlation was observed between the synchronous expression of growth factors and its receptors and histological differentiation. The results suggest that the expression of EGF, TGF-alpha, EGF-R and c-erbB-2 are closely related and plays an important role in the growth and progression of human gastric carcinoma.

Polyvesicular Vitelline Tumor of the Ovary: A case report .: Woo Sung Moon, Dong Geun Lee; Korean J Pathol. 1999;33(11):1102-1106.

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Abstract PDF: Polyvesicular vitelline tumor of the ovary is an extremely rare variant of yolk sac tumor. We present a case of pure polyvesicular vitelline tumor in a 43-year-old woman. Light microscopy revealed a predominantly polyvesicular pattern embedded in mesoblastic stroma with the cysts showing two type of lining; tall columnar and cuboidal, or mesothelioid cells. The lining atypical cells showed occasional mitoses and intracytoplasmic PAS positive hyaline globules. In some areas, the cystic space contained a large amount of intraluminal hyaline material. Immunohistochemically, alpha- fetoprotein and alpha-1-antitrypsin were detected as a fine granular deposit in the cytoplasm of epithelial cells and hyaline globules. Electron microscopically, marked specialization of the vesicular lining cells suggested a differentiation toward gut structures and mature yolk sac.

Relationship between HPV Infection and bcl-2 Protein Expression and Apoptosis in Invasive and In Situ Squamous Cell Carcinoma of the Uterine Cervix.: Myoung Ja Chung, Kyu Yun Jang, Woo Sung Moon, Myoung Jae Kang, Dong Geun Lee; Korean J Pathol. 1999;33(9):702-708.

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Abstract PDF: Human papillomavirus (HPV) 16/18 is a causative agent of uterine cervical carcinoma. HPV 16/18 can alter cell cycle regulation through apoptosis. Bcl-2 is an important regulatory gene of apoptosis. A study was done to evaluate the relation between HPV 16/18 and bcl-2 and apoptosis in 21 cases of carcinoma in-situ (CIS), 5 cases of microinvasive carcinoma and 23 cases of invasive squamous cell carcinoma. HPV 16/18 was detected by hybrid capture system (HCS), bcl-2 protein by immunohistochemical method and apoptosis by using the hematoxylin-eosin stained slide. The results were as follows: Expression of the bcl-2 protein was 43% (9/21) in CIS and 26% (6/23) in invasive carcinoma. Expression of the bcl-2 protein was 42% (5/12) in CIS with HPV 16/18 infection, 44% in CIS without HPV 16/18 infection, 20% (2/10) in invasive carcinoma with HPV 16/18 infection and 31% (4/13) in invasive carcinoma without HPV 16/18 infection. Mean apoptotic index (mAI) was 3.36 in CIS, 5.23 in microinvasive and 6.25 in invasive carcinoma. mAI was 3.66 in CIS with HPV 16/18 infection, 2.86 in CIS without HPV 16/18 infection, 6.18 in invasive carcinoma with HPV 16/18 infection and 6.30 in invasive carcinoma without HPV 16/18 infection. Based on these results, we conclude that there are no correlation between HPV infection and bcl-2, and between HPV infection and apoptosis in invasive and in situ carcinoma of the uterine cervix, and apoptosis is increased according to tumor progression.

Ovarian Mucinous Cystadenocarcinoma with Mural Nodules of Anaplastic Carcinoma: A case report.: Kyu Yun Jang, Woo Sung Moon, Dong Geun Lee; Korean J Pathol. 1999;33(3):217-220.

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Abstract PDF: A case of an ovarian mucinous cystadenocarcinoma with mural nodules of anaplastic carcinoma is reported. The patient was a 46-year-old female with a right ovarian cystic mass and underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. The patient died of the disease in five months. Macroscopically, the right ovarian cyst wall contained numerous well-demarcated mural nodules. Histologically, the cysts were mucinous cystadenocarcinoma, and the nodules were composed of sarcoma-like spindle and polygonal cells with atypia and numerous mitoses. Spindle cells in the mural nodule showed epithelial characteristics by electron microscopy and immunohistochemistry. This case supports an epithelial origin of the mural nodule of anaplastic carcinoma in ovarian mucinous tumors.

Carcinosarcoma in Recurrent Lesion of Serous Cystadenocarcinoma of the Ovary: A case report.: Kyu Yun Jang, Woo Sung Moon, Dong Geun Lee; Korean J Pathol. 1999;33(3):221-224.

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Abstract PDF: Neoplasms showing both carcinomatous and sarcomatous features are well established, and have been reported in practically every organ where carcinoma can occur. But the difference in terminology and difficulties in histopathologic interpretation have hampered adequate understanding of these neoplasms. We report a case of carcinosarcoma in the recurrent form of serous cystadenocarcinoma of the ovary. The patient was a 64-year-old female who underwent total hysterectomy and bilateral salpingoophorectomy three years ago, due to perforated papillary serous cysta denocarcinoma of the right ovary. Recurrent pelvic masses contained both carcinomatous and sarcomatous components. Morphological transition between carcinomatous and sarcomatous components, and epithelial characteristics in the sarcomatous component by immunohistochemistry were recognized. We postulate the histopathogenetic mechanism based on the phenotypic conversion of carcinoma into sarcoma in the carcinosarcoma.

Primary Squamous Cell Carcinoma of the Endometrium Covering Submucosal Leiomyoma.: Myoung Ja Chung, Dong Geun Lee; Korean J Pathol. 1999;33(1):65-67.

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Abstract PDF: Primary squamous cell carcinoma of the endometrium is exceedingly rare. To be accepted as a primary carcinoma of the endometrium, the tumor must satisfy the criteria estalished by Fluhmann: There must be; 1) no coexisting endometrial adenocarcinoma, 2) no connection between the endometrial tumor and the squamous epithelium of the cervix, and 3) no squamous cell carcinoma of the cervix. We recently experienced a case of primary squamous cell carcinoma of the endometrium covering the submucosal leiomyoma in a 68-year-old female patient. On gross examination a submucosal leiomyoma covered by an irregular, dirty endometrium was found. On histologic examination the endometrium covering the leiomyoma revealed invasive, well differentiated squamous cell carcinoma. The uterine cervix showed no evidence of malignancy. In situ PCR using a probe for HPV 16/18 was negative in the carcinoma tissue.

Retroperitoneal Duplication Cyst Associated with Heterotopic Pancreas: A case report.: So Yeong Oh, Myoung Ja Chung, Dong Geun Lee, Ho Yeul Choi; Korean J Pathol. 1998;32(9):687-690.

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Abstract: Occurrence of a retroperitoneal duplication cyst associated with a heterotopic pancreas is rare. We report a case of a retroperitoneal duplication cyst associated with a heterotopic pancreas. A 35-year-old male was admitted, presenting with back pain. A pelvic computed tomographic scan disclosed a 10 cm-sized cystic mass filling the lower pelvis and displacing the rectosigmoid colon anteriorly. Histologically, the cyst wall was lined partly by mucin-secreting columnar epithelium, showing atypical hyperplasia and partly by a gastric fundic-type and a colonic-like mucosa. Beneath the epithelium, organized bundles of smooth muscle were arranged in two layers analogous to smooth muscles layers of the bowel and a small piece of pancreatic tissue were present in the smooth muscle wall of the cyst.

Histopathologic Findings & Expression of bcl-2 of the Endometrium Analysis of 1,000 consecutive biopsies of uterine bleeding .: Hye Kyung Lee, Dong Geun Lee, Ho Lee, Sang In Shim; Korean J Pathol. 1998;32(3):208-214.

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Abstract PDF: We evaluated 1,000 consecutive endometrial curettage samples obtained over a 30 month period. The clinico-pathologic correlation was analysed according to Hendrickson's five criteria based on the practical view. The causes of uterine bleeding in decreasing order of occurrence were as follows: 1) hormonal imbalance lesions (49.2%) encompassing glandular and stromal breakdown suggesting anovulatory bleeding, proliferative phase endometrium, and disordered proliferative endometrium, 2) pregnancy associated lesions (24.2%), 3) organic lesions (13.5%), 4) endometrial hyperplasia (6.9%), and 5) inadequate specimen (6.2%). According to age, pregnancy related lesions were most frequent in the third decade. In the fourth, fifth, and sixth decades, hormonal imbalance lesions were the most common cause. In approximately 30% of the samples, there were two or three morphologic patterns such as anovulatory bleeding with an endometrial polyp, postabortal bleeding with inflammation, and glandular-stromal dissociation with a polyp, which suggested there was a variable histologic morphology in the same disease spectrum. Using immunohistochemical techniques we studied the hormonal dependency of bcl-2 oncoprotein in anovulatory bleeding, endometrial hyperplasia, and proliferative endometrium. 70% of anovulatory bleeding specimens showed weak positivity in the epithelial cytoplasm, and all cases of endometrial hyperplasia and carcinoma showed a strong positivity. These results suggest that there is a estrogenic hormonal dependency of apoptosis in the endometrium.

Menetrier's Disease Report of two cases.: Joo Heon Kim, Dong Geun Lee, Sang Woo Juhng; Korean J Pathol. 1998;32(2):142-146.

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Abstract PDF: Menetrier's disease is characterized by enlarged gastric folds with foveolar hyperplasia and cystic dilatation of gastric glands. The additional biochemical features of hypoproteinemia, hypochlorhydria, and increased gastric mucus are often encountered. The pathogenesis and etiologic factors have not been clearly defined. In this report, we present two cases of Menetrier's disease in the stomach, one occurring in a 38-year-old male, associated with massive hematemesis, and the other in a 39-year-old male. Grossly, both cases showed marked giant gastric rugal folds resembling cerebral convolutions, sparing the antral portion. Microscopically, the giant gastric rugal folds consisted of the striking foveolar hyperplasia accompanied by an occasional presence of the smooth muscle fibers from the muscularis mucosa. The immunohistochemical stain revealed an intense positive reaction for transforming growth factor-alpha (TGF-alpha) and epidermal growth factor receptor (EGF-R) in the majority of mucous cells throughout the gastric mucosa and parietal cells, but did not reveal for epidermal growth factor (EGF). We suggested that TGF-alpha and EGF-R might be involved in the pathogenesis of Menetrier's disese.

Fine Needle Aspiration Cytology of Lipoblastoma: A Report of Two Cases.: So Yeong Oh, Myoung Ja Chung, Woo Sung Moon, Myoung Jae Kang, Dong Geun Lee; Korean J Cytopathol. 1998;9(2):241-244.

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Abstract PDF: Lipoblastoma is a rare benign neoplasm occurring exclusively in children below the age of three years. It affects chiefly the upper and lower extremities, and less commonly head and neck area, trunk, mediastinum, mesentery, and retroperito neum. We present two cases of lipoblastoma occurring in the mediastinum of a 21-month-old boy and in the back of a 15-month-old boy. The characteristic features of Fine needle aspiration cytology smears were the presence of immature fat cells in the form of spindle-shaped cells, stellate cells and vacuolated lipoblasts along with lipocytes against a myxomatous background. Two tumors were histologically confirmed to be lipoblastomas. Lipoblastoma can be cytologically diagnosed by considering the cytologic findings and the age of the patient.

Fine Needle Aspiration Cytologic Findings of Metastatic Sex Cord Tumor with Annular Tubules to the Neck.: So Yeong Oh, Myoung Jae Kang, Myoung Ja Chung, Woo Sung Moon, Dong Geun Lee; Korean J Cytopathol. 1997;8(2):185-189.

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Abstract PDF: A sex cord tumor with annnular tubules is a relatively rare ovarian neoplasm. The cytologic findings from a fine needle aspiration biopsy of neck metastasis of a sex cord tumor with annnular tubules are described. The origin of the neck metastasis was the right ovary, and the tumor was diagnosed six years ago. The cytologic findings were characterized by tumor cells arranged in solid or follicular patterns. The tumor cells formed rosette-like or complex tubular structures with central rounded or coalesced hyaline materials. It was difficult to distinguish this tumor cytologically from granulosa cell tumor, thyroid follicular neoplasm, Sertoli-Leydig cell tumor, and Brenner tumor, but complex tubular structures were helpful in discriminating between these tumors.

Fine Needle Aspiration Cytology of Extraskeletal Mesenchymal Chondrosarcoma.: Myoung Ja Chung, So Yeong Oh, Myoung Jae Kang, Dong Geun Lee, Ho Yeul Choi, Sang Ho Kim; Korean J Cytopathol. 1997;8(2):194-198.

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Abstract PDF: Extraskeletal mesenchymal chondrosarcoma is a relatively rare tumor and its cytologic findings have rarely been reported. We experienced a case of mesenchymal chondrosarcoma of soft tissue of the right lateral neck diagnosed by fine needle aspiration biopsy in a 59 year-old man. Cytologic findings showed two cell components. One was an undifferentiated, small cell component with moderate amount of cytoplasm and spindle nuclei. The second population was a chondroid component. These cytologic findings were diagnostic to mesenchymal chondrosarcoma.

Expression of p53 Protein in Gastric Adenoma and Carcinom.: So Yeong Oh, Myoung Jae Kang, Dong Geun Lee, Ho Youl Choi, Sang Ho Kim; Korean J Pathol. 1996;30(10):886-892.

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Abstract PDF: In the present study, immunohistochemical detection of p53 oncoprotein was performed to determine whether the grade of differentiation and the histologic type of gastric adenocarcinoma, and the degree of atypia accompanied with adenoma can be related to p53 mutation. Paraffin sections of 22 gastric adenomas and 56 gastric adenocarcinomas were examined for the overexpression of p53 oncoprotein with the avidin-biotin peroxidase complex staining procedure. The obtained results were as follows; 1. All the 22 cases of adenomas and 16 cases of well differentated adenocarcinomas showed uniformly negative staining. 2.Seven of 18 cases of moderately differentiated adenocarcinomas(39%), and five of 30 cases of poorly differentiated adenocarcinomas(17%) exhibited p53 protein expression. 3. Three of 29 cases of diffuse type (10%) and 9 of 19 cases of intestinal type(47%) exhibited p53 protein expression. These results suggest that p53 mutation is important in carcinogenesis of the intestinal type of gastric adenocarcinoma, and there is no correlation between the differentiation of gastric adenocarcinoma and the degree of p53 oncoprotein overexpression.

Goblet Cell Carcinoid of the Appendix: A case report.: Joo Heon Kim, Ho Lee, So Young Oh, Myoung Jae Kang, Ho Yeul Choi, Dong Geun Lee; Korean J Pathol. 1996;30(9):839-842.

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Abstract PDF: Carcinoid tumors of the appendix are common incidental findings, but appendiceal tumors with histologic features of both carcinoids and adenocarcinomas are rare, and their biologic behavior and histogenesis are still unclear. We report a case of goblet cell carcinoid of the appendix in a 54-year-old male, who exhibited pain in the right lower abdomen. Microscopically, the tumor contained smooth-bordered, widely separated nests composed of tumor cells with abundant mucin. The principal tumor cell type had a close resemblance to the normal goblet cell. Histochemically, the tumor cells revealed positive reaction for PAS and alcian blue stain. Immunohistochemically, the tumor showed strong reactivity for carcinoembryonic antigen, chromogranin and, neuron specific enolase but none for cytokeratin and epithelial membrane antigen.

Detection of HBV DNA in Needle Biopsied Paraffin Embedded Liver Tissues of Chronic Hepatitis B Patients by PCR: Comparison with Serological and Immunohistochemical Studies.: Hye Soo Lee, Kahng Yeul Oh, Joo Heon Kim, Yoon Jeong Kim, Sam Im Choi, Dong Geun Lee, Sang Ho Kim; Korean J Pathol. 1996;30(6):495-504.

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Abstract PDF: In this study, the prevalence of Hepatitis B virus(HBV) DNA in the needle biopsied paraffin embedded liver tissues of chronic hepatitis B patients by rapid nested PCR was examined. DNA was extracted by NaOH with boiling, and amplified by rapid air thermocycler with glass capillary tubes and nested PCR with two primer sets specific for the surface and the core genes of HBV. The PCR results were compared to that of serum HBeAg, serum HBV DNA by dot blot hybridization with a radioactive DNA probe, and tissue immunohistochemical (HBsAg/ HBcAg) studies. Among 44 patients with chronic hepatitis with serum HBsAg positivity, HBV DNA could be detected by PCR in 43 liver tissues (98%). This results were comparable to the positive rates of 94%(31/33) for serum HBV DNA, 80%(35/44) for serum HBeAg, and 59%(26/44) and 75%(33/44) for tissue HBsAg and HBcAg, respectively. The accordance rate between tissue PCR and serum DNA probe testing was 91%. The results indicate that HBV DNA detection by rapid nested PCR of paraffin embedded liver tissues by needle biopsy is a more sensitive method to detect the HBV DNA carrier than the serum HBeAg or tissue HBsAg/HBcAg status, and is well correlated with the result of serum HBV DNA probe testing. Therefore this method is a practical indicator for the diagnosis and replication status in retrospective analysis.

Lymphocytic Hypophysitis Presenting with Diabetes Insipidus in a Man: Report of a case.: Woo Sung Moon, Myoung Jae Kang, Dong Geun Lee, Hyung Il Kim, Ho Yeul Choi, Sang Ho Kim; Korean J Pathol. 1996;30(6):528-532.

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Abstract PDF: Lymphocytic hypophysitis is an autoimmune disorder of the pituitary gland which usually occurs in a woman in the postpartum period. Diabetes insipidus is not a major clinical feature of this disorder. We report a case of a 22-year-old man with lymphocytic hypophysitis which presented with diabetes insipidus and also involved his cavernous sinus. This represents the seventh reported and the youngest case of a man with lymphocytic hypophysitis. A comparative study of all six male patients is also presented. We suggest diabetes insipidus should be added to the spectrum of clinical manifestations of this disorder.

Adrenal Pseudocyst as a Result of Longterm Intake of Steroid Hormone.: Woo Sung Moon, So Yeong Oh, Myoung Jae Kang, Dong Geun Lee, Ho Yeul Choi, Sang Ho Kim; Korean J Pathol. 1996;30(4):355-357.

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Abstract PDF: Adrenal pseudocysts are uncommon lesions which usually occur as a result of hemorrhage within the adrenal tissue. Adrenal hemorrhage is usually associated with severe stress, sepsis, pregnancy, syphilis, leukemia, or anticoagulant therapy but during steroid therapy, it is very rare. We report a case of adrenal pseudocyst that resulted from hemorrhage into the adrenal gland and is probably related to the exogenous administration of steroids. The patient was a 57-year-old woman who was treated with oradexon for 20 years for the treatment of a maculopapular lesion on her thigh as well as for arthritis. She underwent a right adrenalectomy due to the adrenal cystic mass. The wall of the cystic mass was composed of a thick layer of hyalinized fibrous tissue with remnants of adrenal cortical tissue on the outer aspect. The inner surface had no lining cells and the wall of the cyst contained many calcified plaques with hemosiderin pigment.

Immunohistochemical and Ultrastructural Studies on the Histogenesis of Thyroid Undifferentiated Carcinoma.: Myoung Ja Jeong, Woo Sung Moon, Young Hye Lee, Myoung Jae Kang, Ho Yeul Choi, Sang Ho Kim, Dong Geun Lee; Korean J Pathol. 1995;29(6):756-765.

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Abstract PDF: Histologic, immunohistochemical and ultrastructural studies were performed on 6 cases of undifferentiated thyroid carcinoma to study the histogenesis of the undifferentiated thyroid carcinoma, to determine the most useful markers for diagnosing these tumors and to investigate the nature of osteoclast-like giant cells rarely observed in these tumors. For the immuno-histochemical study, a panel of antibodies to epithelial (cocktailed keratin, low molecular weight keratin, CEA), mesenchymal(vimentin, desmin, actin, FVIIIRAg) endocrine(calcitonin, chromogranin), lymphocytic(LCA), histiocytic(alpha-l-ACT, alpha-1-AT, lysozyme, CD68), and Schwann cell(S-100 protein) markers were used. The following results were obtained; 1) Well differentiated carcinoma was associated with 2 cases of spindle cell type and 1 case of giant cell type of undifferentiated thyroid carcinoma and a transitional zone between the well differentiated and undifferentiated lesions was observed. 2) All of the examined cases expressed keratin, and 3 tumors expressed CEA. 3) All the mesenchymal markers, LCA, S-100 protein, calcitonin, and chromogranin were not expressed. Vimentin was coexpressed with keratin in 4 cases. 4) Osteoclast-like giant cells were observed in 1 case of spindle cell type. They expressed CD68 but not keratin. 5) Ultrastructural study revealed the desmosomes between the tumor cells and non-neoplastic, follicular, thyroid epithelial cells. The above results indicate that undifferentiated thyroid carcinoma originates from follicular epithelial cell, keratin is the most useful marker for diagnosis of this tumor, and the osteoclast-like giant cells are histiocytic in nature and reactive, rather than neoplastic.

Pleomorphic Xanthoastrocytoma in a 58-year-old Woman: A case report.: Joo Heon Kim, Myoung Jae Kang, Dong Geun Lee, Ho Yeul Choi, Sang Ho Kim, Min Cheol Lee; Korean J Pathol. 1995;29(1):122-125.

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Abstract: A case of left parietal pleomorphic xanthoastrocytoma that occurred in a 58-year-old woman is reported clinicopathologically. Histopathologic diagnosis of pleomorphic xanthoastrocytoma was made because of the unique pleomorphic histologic features, positive glial fibrillary acidic protein in immunohistochemical staining. The flow cytometric analysis reveals DNA aneuploidy and relatively high S-phase fraction. The pleomorphic xanthoastrocytoma is considered as a special subgroup of glioma on the basis of superficial cortical location, GFAP expression, marked cellular atypia, xanthomatous cells, and relatively favorable prognosis.

Immunohistochemical Study on the Proliferative Activity of Human Thyroid Tumors.: Myoung Jae Kang, Young Jin Jeong, Woo Sung Moon, Myoung Ja Jeong, Joo Heon Kim, Dong Geun Lee, Ho Yeul Choi, Sang Ho Kim; Korean J Pathol. 1995;29(1):77-84.

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Abstract PDF: For the estimation of the proliferative activity, related to the biologic behaviour, malignant potential, and prognosis, of human thyroid tumors, PCNA(proliferating cell nuclear antigen) immunohistochemical staining was performed on paraffin-embedded sections of 9 normal thyroid tissues, 9 adenomatous goiters, 9 follicular adenomas, 4 Hurthle cell tumors, 12 papillary carcinomas, 4 follicular carcinomas, and 3 anaplastic carcinomas. The results were as follows: 1) The PCNA labeling indices in adenomatous goiter, follicular adenoma, and Hurthle cell tumor were 1.1, 1.5, and 2.4, respectively. They were significantly higher than the labeling index in normal thyroid. 2) The PCNA labeling indices in papillary carcinoma and follicular carcinoma were 3.5 and 4.4, respectively. They were significantly higher than the labeling indices in adenomatous goiter and follicular adenoma, but there was no significant difference between papillary and follicular carcinoma. 3) The PCNA labeling index in anaplastic carcinoma, 14.1, was significantly higher than those in benign and other malignant tumors. According to the results, the PCNA labeling index was well correlated with the malignant potential of a tumor. So the PCNA immunohistochemical staining is thought to be a useful method for the evaluation of the malignant potential and prognosis of a tumor.

Percutaneous Fine Needle Aspiration Cytology of Adrenal Cortical Carcinoma: A Case Report.: Myoung Ja Jeong, Ho Lee, Myoung Jae Kang, Dong Geun Lee, Ho Yeul Choi, Sang Ho Kim; Korean J Cytopathol. 1995;6(1):58-61.

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Abstract PDF: Fine needle aspiration(FNA) biopsy has become the procedure of choice for initial diagnosis of adrenal masses. However, there have been relatively few reports discussing the FNA cytologic features of adrenal cortical carcinoma. Recently, we experienced a case of FNA cytology of bilateral adrenal cortical carcinoma in a 61-year old man. The smear revealed loosely cohesive pleomorphic tumor cells with hemorrhagic and necrotic background. The tumor cells showed oval to spindle hyperchromatic nuclei and prominent nucleoli with frequent mitotic figures. The cytoplasm of tumor cells was relatively abundant and sometimes vacuolated. These cytologic findings were interpreted as an adrenal cortical carcinoma, undifferentiated pattern.

Histological, Enzyme Histochemical, and Electron Microscopic studies of the Rat Kidney Following Administration of Folic Acid.: Myoung Jae Kang, Woo Sung Moon, Dong Geun Lee, Ho Yeul Choi, Sang Ho Kim, Kyu Hyuk Cho; Korean J Pathol. 1994;28(5):449-459.

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Abstract PDF: To investigate the morphologic evidence of acute renal failure by folate, histological, histochemical (PAS), enzyme histochemical (Na-K-ATPase, G6PD, and ALP), and ultrastructural studies were performed. The results are as follows: l) Oliguria was most severe 3 hours after folate and the urine volume was 24.8% that of the control group. 2) Histologically, dilatation of tubules, degeneration and focal necrosis of the cortical tubules, and PAS(+) droplets in the tubular lumen were noted. And also frequent mitoses, mild interstital connective tissue proliferation, and neutrophilic infiltrates were observed in the late stage. 3) On enzyme histochemical examination, the activities of Na-K-ATPase and ALP were decreased, but G6PD activity was increased in comparison with the control group. 4) The ultrastructural studies revealed cytoplasmic vacuoles, apical cytoplasmic blebbing, dense bodies, mildly swollen mitochondria, dilated endoplasmic reticulum, loss bf brush border of the proximal tubules, and loss of microvilli of the thin limb of Henle's loop. Later, marked attenuation or loss of infoldings of basal plasma membrane of the cortical tubules was recognized. According to above results, the cause of acute renal failure by late is thought to be the injuries of tubular epithelial cells including sodium pump secondary to tubular obstruction.

Embryonal Rhabdomyosarcoma of Urinary Bladder Diagnosed by Urine Cytology: A Case Report.: Joo Heon Kim, Ho Lee, Myoung Jae Kang, Dong Geun Lee, Sang Ho Kim; Korean J Cytopathol. 1994;5(1):71-73.

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Abstract PDF: Rhabdomyosarcomas are found mainly in young patients, but rare in adults. A correlated cytological and histologic study of one case of embryonal rhabdomyosarcoma is presented. The cytologic appearance of the urine smear corresponded well with the histologic findings. Cytologically, two main cell types were distinguished; a predominant primitive, small round cell with scant cytoplasm and a large cell with abundant cytoplasm. The cytologic feature proving rhabdomyoblastic differenti-ation, such as cross-striation, was absent.

Eccrine spiradenoma: A report of two cases.: Woo Sung Moon, Dong Geun Lee, Myoung Ja Jeong, Myoung Jae Kang, Ho Yeul Choi, Sang Ho Kim; Korean J Pathol. 1993;27(4):402-406.

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Abstract PDF: Eccrine spiradenomas are clinically characterized by a solitary, tender mass and they are situated on the upper parts of the body, predominantly on the ventral aspect. We herein report two cases of eccrine spiradenoma in 35-year-old man and 53-year-old woman, which located on upper extremity and inguinal region. The masses are round, well circumscribed and measuring 0.7x0.5x0.5 cm, 5x4.5x3 cm in size, respectively. Histopathologically, the tumor consists of masses of two types of cells, intensely staining cells and pale staining cells, usually arranged in chains, cords and pseudoglands. Immunostainings for low molecular cytokeratin, high molecular cytokeratin, carcinoembryonic antigen, and S-100 protein show positivity in neoplastic cells. Electron microscopically, the tumor was composed of three types of cells, i. e. 1) round or ovoid tumor cells in shape with scanty cytoplasm and poorly developed intracytoplasmic orgenelles, 2) spindle shaped dark cells interconnected by desmosomes, 3) large epithelial cells with abundant cytoplasm and cytoplasmic intermediate filaments which formed glandular structures. The large epithelial cells joint each other by desmosomal attachments and luminal cells featured small numbers of microvilli, but either secretory granules nor ductal type granules were noticed.

Dedifferentiated Liposarcoma of the Retroperitoneum: A case report.: Woo Sung Moon, Myoung Ja Jeong, Dong Geun Lee, Ho Yeoul Choi, Sang Ho Kim; Korean J Pathol. 1993;27(3):296-298.

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Abstract PDF: We report a case of dedifferentiated liposarcoma of retroperitoneum as a recurrent form in a 41 year old male. The patient received a extirpation for retroperitoneal mass and diagnosed as myxoid liosarcoma 4 years ago. The patient experienced 3 recurrences over a period of 4 years and diagnosed as myxoid liposarcoma in the second, third recurrence also. Histologically, the mass was composed of several clearly distinct elements : well differentiated liposarcoma, myxoid liposarcoma, myxoid malignant fibrous histiocytoma, poorly differntiated sarcoma, and fibrosarcoma. Immunohistochemically, S-100 protein was expressed in the area of spindle cell sarcoma, well differentiated liposarcoma, and malignant fibrous histiocytoma but alpha-1-antichymotrypsin was only expressed in the area of myxoid malignant fibrous histiocytoma.

Meningeal Melanocytoma Associated with Ota's Nevus: Report of a case.: Woo Sung Moon, Joo Heon Kim, Dong Geun Lee, Ho Yeul Choi, Sang Ho Kim; Korean J Pathol. 1992;26(6):605-609.

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Abstract PDF: Primary meningeal melanocytoma of the central nervous system is extremely rare. We report a case of meningeal melanocytoma associated with Ota's nevus as a recurrent form in a 53-year old male. The meningeal melanocytoma was removed from right parietooccipital lobe 4 years ago and recurred in right parietal, occipital and left frontal lobes. Ultrastructurally, the tumor cells were characterized by the presence of numerous melanosomes and premelanosomes in their cytoplasm. Moreover, the tumor was lacking in histologic and ultrastructural features of pigmented meningioma, melanotic schwannoma and prolonged clinical course was different from primary meningeal melanoma or metastatic malignant melanoma.

Sex Cord Tumor with Annular Tubules Associated with Turner's Syndrome: Report of a case.: Woo Sung Moon, Soo Hun Kim, Dong Geun Lee, Sang Ho Kim, Sung Nam Cho, So Ja Jin; Korean J Pathol. 1992;26(5):517-523.

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Abstract PDF: An ovarian sex cord tumor with annular tubules(SCTAT) in an 18-year-old woman who had secondary amenorrhea but not Peutz-Jeghers syndrome was studied by light and electron microscopy. Her clinical features were consistent with those of Turner's syndrome, i.e, shortness of stature, webbing of the neck, scanty or absent axillary and pubic hairs, lower hair line with streak gonad. Chromosomal analysis revealed 45, X/46, XX karyotype. The patient has been well and disease free for a period of 2 years after surgical removal of tumor. Histologically, the tumor was composed of nests of cells arranged in simple and complex annular tubules with central acidophilic hyaline bodies. Ultrastructurally, the cells had deeply indented nuclei and the cells were joined by specialized intercellular junctions along their lateral adjacent borders. Central acidophilic hyaline body consisted of concentric lamellae of basal lamina, but Charcot-Boettcher filaments were not observed.

An Experimental Study of DMBA (9,10-Dimethyl-1,2-Benzanthracene) Induced Knee Joint Tumors in the Rats.: Myung Jae Kang, Dong Geun Lee, Sam Im Choi, Sang Ho Kim; Korean J Pathol. 1988;22(4):424-434.

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Abstract PDF: For the morphological analysis of DMBA (9,10-diemethyl-1,2-benzanthracene) induced tumor, thirty Sprague-Dawley rats were received 0.1 ml of a 2% paraffin solution of DMBA into the knee joint cavity, which was repeated three times at an interval of 4 weeks. The induced tumor masses were removed at the 12th week after the first injection. Histological and histochemical examinations (H & E, PAS, alcian blue, Van Gieson, prussian blue, reticulin, PTAH stain) and enzyme histochemical examinations (acid phosphatase, alkaline phosphatase, alpha-naphthyl acetate esterase) were performed. The results were as follows: 1) By the 12th week after the first injection of DMBA, the tumor incidence rate was 20 percent. 2) On histological and histochemical examination, most of the induced tumor disclosed the features of the fibrous histiocytoma originating from mesenchymal cells, and the remains sweat gland adenoma and adenocarcinoma originating from epithelial cells. 3) On enzyme histochemical examination, most of the mesenchymal cell-derived tumor cells showed positive reactions for acid phosphatase and alpha-naphthyl acetate esterase, which were similar characteristic features of enzyme stains as shown in the component cells of fibrous histiocytoma.

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