- Chronic Intestinal Pseudoobstruction Associated with Inflammatory Visceral Neuropathy: A Case Report.
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Young Kyung Bae, Joon Hyuk Choi, Mi Jin Kim, Dong Sug Kim, Won Kyu Park, Jae Hwang Kim
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Korean J Pathol. 2004;38(3):191-195.
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- The pathogenesis of chronic intestinal pseudoobstruction (CIP) presents a broad spectrum of etiologies. Among them, visceral neuropathy and myopathy are two major pathologic conditions. We report here on a very rare case of CIP associated with inflammatory visceral neuropathy involving the terminal ileum, appendix and entire colon in a 64-year-old woman who did not have any detectable neoplasm or family history of this disease. Microscopically, the submucosal and myenteric plexuses showed a severe and diffuse lymphoplasmacytic infiltrate with degenerative changes of the ganglion cells and nerve fibers. The pathogenesis of the inflammatory reaction is unclear for our patient, but we think that this would be a rare example of idiopathic and sporadic visceral neuropathy resulting in chronic intestinal pseudoobstruction.
- Meningeal Hemangiopericytoma in a Newborn: A Case Report.
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Dong Sug Kim, Seong Ho Kim, Woo Mok Byun, Jeong Ok Hah
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Korean J Pathol. 2002;36(2):132-135.
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- Several, but not many, cases of congenital meningeal hemangiopericytoma have been described to date. Herein, a case of meningeal hemangiopericytoma in a newborn is described. The patient was a 2-week-old boy with expanded fontanelles and frequent vomiting. A 5 cm sized mass was found in the left temporo-parietal lobe, which was well circumscribed and lobulated. Histologically the tumor was compatible with anaplastic (malignant) hemangiopericytoma, which showed pleomorphic nuclei, frequent mitotic figures and extensive hemorrhagic necrosis. The tumor cells were immunoreactive for vimentin, but negative for CD34, desmin and S-100 protein. Differential diagnosis for meningeal hemangiopericytoma was discussed, and the fact that meningeal hemangiopericytoma might have occurred congenitally was emphasized.
- Nasal Inverted Papilloma Associated With Squamous Cell Carcinoma: A Report of Two Cases.
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Mi Jin Gu, Dong Sug Kim, Young Kyung Bae, Yong Dae Kim
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Korean J Pathol. 2001;35(3):248-281.
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- Nasal inverted papilloma (IP) is a benign neoplasm that may be associated with squamous cell carcinoma (SCC). Several studies have suggested that human papilloma virus 16/18 (HPV 16/18) and p53 are closely related to the pathogenesis of IP with transformation to squamous cell carcinoma (IP-SCC). This study was conducted to investigate the role of HPV 16/18 and p53 in the pathogenesis of IP-SCC using immunohistochemistry. We studied two cases of IP-SCC and 10 cases of IP. None of the IP cases presented positivity for HPV 16/18 or p53 protein. Two cases of IP-SCC showed negative reactions for HPV 16/18. The SCC portion of the IP-SCC showed strong positivity for p53, while the IP portion of the IP-SCC was negative for p53.
MIB-1 labeling index (LI) was estimated in the IP cases and the IP-SCC as well. In terms of MIB-1 LI, there was no statistical significance between IP and IP-SCC, and between the IP portion and the SCC portion in the cases of IP-SCC. In conclusion, we believe that alteration of the p53 protein is related to IP with malignant transformation, but further studies are required to investigate the correlation of HPV 16/18 and p53 in the pathogenesis of IP with malignant transformation, and the significance of the MIB-1 LI and p53 as biomarkers in IP.
- Choroid Plexus Carcinoma: A Report of Two Cases.
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Young Ran Shim, Mi Jin Gu, Dong Sug Kim, Oh Lyong Kim, Woo Mok Byun, Yong Jin Kim
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Korean J Pathol. 2001;35(2):176-179.
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- Choroid plexus carcinoma (CPC), a frankly malignant epithelial neoplasm derived from choroid plexus epithelium, is a rare tumor with a predilection for infants and children. It may be difficult to histologically differentiate it from choroid plexus papilloma, anaplastic ependymoma, medulloblastoma, germ cell tumors, and metastatic carcinoma. We examined two cases of CPC. One is a 12-month-old boy, and the other is a 13-month-old boy. Both patients present lateral ventricular masses with extensive hydrocephalus. Histologically, both tumors show papillary growth in most area, and focal solid growth. The tumor cells show marked nuclear pleomorphism and frequent mitoses on squash and hematoxylin-eosin slides. Immunohistochemically, both tumors are positive for cytokeratin, vimentin, and S-100 protein; but they are negative for glial fibrillary acidic protein, -fetoprotein, and placental alkaline phosphatase. Both tumors show diffuse and strong positivity for p53. The MIB-1 labelling index is 23.6% and 15.82%, respectively. We report two cases of typical CPC, and we briefly discuss differential diagnosis with review of literatures.
- Expressions of MIB-1, p53 and CEA in Endocervical Glandular Lesions.
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Mi Jin Kim, Young Gi Lee, Dong Sug Kim
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Korean J Pathol. 2001;35(1):41-47.
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- BACKGROUND
Endocervical glandular lesions include glandular atypia (GA), endocervical glandular dysplasia (EGD), adenocarcinoma in situ (AIS), and invasive adenocarcinoma (IA). The diagnosis of malignant glandular lesions is occasionally difficult to distinguish from benign mimickers, and the morphologic features of EGD remain unsettled.
METHODS
Immunohistochemical stains for MIB-1, p53 and CEA were performed on 81 cases of paraffin-embedded endocervical glandular lesions including 22 IA, 15 AIS, 15 EGD, 13 GA, 8 microglandular hyperplasia (MGH) and 8 tubal metaplasia (TM).
RESULTS
The MIB-1 labelling index of IA was 59.68%, 69.53% for AIS, 26.60% for EGD, 16.03% for benign. p53 overexpression was noted in 4 (18%) cases of IA, 3 (20%) of AIS, but none of EGD and benign lesions. It was Interesting to note that one case of MGH showed p53 staining in low intensity. Diffuse strong cytoplasmic CEA positivity was present in all of IA and AIS, whereas seven (47%) of 15 EGD and 12 (41%) of 29 benign lesions showed focal cytoplasmic CEA positivity. There were significant differences in MIB-1 and CEA immunostainings among the adenocarcinoma, EGD, and benign glandular lesions. Adenocarcinoma was closely related to p53 overexpression, although occurring in a low percentage of the cases.
CONCLUSION
MIB-1 immunostaining can be useful in differentiating among endocervical adenocarcinoma, endocervical glandular dysplasia and benign glandular lesions. p53 overexpression might be helpful in the diagnosis of adenocarcinoma.
- Telomerase mRNA Expression by In Situ Hybridization in Premalignant Lesions and Carcinomas of the Breast.
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Young Kyung Bae, Dong Sug Kim, Soo Jung Lee, Koing Bo Kwun
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Korean J Pathol. 2001;35(1):53-59.
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- BACKGROUND
Telomerase is a ribonucleoprotein, DNA polymerase that synthesizes telomere repeats onto chromosomal ends and maintains telomere length. Telomerase activity has been detected in a broad range of human malignant neoplasms, but not in normal somatic cells. So, activation of telomerase may represent an essential step in the malignant transformation of cells. However, the expression of telomerase in premalignant lesions remains relatively unexplored. This study was conducted to investigate the reactivation of telomerase in the carcinogenesis of human breast tissue.
METHODS
In situ hybridization for the telomerase RNA component (human telomerase mRNA; hTR) was used in a normal breast tissue (n=41), florid ductal hyperplasia (FDH) (n=10), atypical ductal hyperplasia (ADH) (n=3), ductal carcinoma in situ (DCIS) (n=44) and invasive carcinoma (n=33). hTR expression in relation to p53 status and the pathologic parameters in breast cancer was also studied.
RESULTS
Expression of hTR was demonstrated in 13 samples (31.7%) of normal breast tissues, 4 (40%) of FDH, 3 (100%) of ADH, 42 (95.5%) of DCIS, and 33 (100%) of invasive carcinoma. The rate of hTR expression of ADH was significantly different from that of FDH (p<0.05), and there were no differences in hTR expression rates among ADH, DCIS and invasive carcinomas. There was no correlation between hTR expression and nuclear grade, tumor size, and p53 status in invasive carcinomas.
CONCLUSION
These results suggest that telomerase activation may be an early event and an essential step in the carcinogenesis of human breast tissue, and that telomerase has no correlations with p53 status and prognostic parameters.
- Invasive Lobular Carcinoma of the Breast Associated with Mixed Lobular and Ductal Carcinoma In Situ: A Case Report.
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Ji Shin Lee, Hyung Seok Kim, Jong Jae Jung, Young Bog Kim, Dong Sug Kim
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Korean J Pathol. 2001;35(1):89-91.
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- Mixed lobular and ductal carcinoma in situ is very rare. We recently experienced a case of invasive lobular carcinoma associated with mixed lobular and ductal carcinoma in situ in a 50-year-old female. The infiltrating portions of lobular carcinoma revealed thread-like strands of tumor cells. Lobular carcinoma in situ with pagetoid spread into the ducts and ductal carcinoma in situ of the predominantly papillary type were also noted in the same mass.
- A Clinicopathologic Study of 53 Gastrointestinal Mesenchymal Tumors.
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Young Kyung Bae, Dong Sug Kim, Mi Jin Gu, Joon Hyuk Choi, Mi Jin Kim, Young Jin Kim, Won Hee Choi, Sun Kyo Song, Koing Bo Kwun
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Korean J Pathol. 2000;34(11):909-918.
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- The gastrointestinal mesenchymal tumors (GIMTs) form a heterogenous group with controversy centering on both the cell of origin and the prediction of clinical behavior. They include a small group of tumors with mature smooth muscle or Schwann cell differentiation and a larger group with inconsistent or no evidence of differentiation. Tumors in the latter are now referred to as gastrointestinal stromal tumors (GISTs). A clinicopathologic and immunohistochemical study was performed on 53 cases of GIMTs to identify cellular differentiation and predictors of clinical behavior.
Fifty three cases of GIMTs could be histologically and immunophenotypically divided into three categories, 6 leiomyomas (11.3%), 4 schwannomas (7.6%), and 43 GISTs (81.1%). All leiomyomas (SMA desmin ) and schwannomas (S-100 ) were located in stomach and negative for CD34 and CD117. Thirty nine cases of GISTs were either CD34 (n=26) or CD117 (n=23) immunoreactive. Of these 39 GISTs, 26 were negative for myoid (SMA, desmin) and neural marker (S-100), 10 SMA desmin-S-100-, two SMA-desmin-S-100 , and one SMA desmin-S-100 . Two out of 4 GISTs, which were negative for CD34 and CD117, were immunohistochemically considered leiomyosarcoma (SMA desmin ). GISTs of small intestine had a tendency to be malignant than those of stomach. Pathologic grade of GISTs was not correlated with cellular differentiation. In 29 GISTs with clinical follow-up information, tumor size, mitotic counts, Ki-67 labelling index, tumor necrosis, mucosal invasion, and CD34 expression were significantly correlated with metastasis/recurrence.
- Development of a CD-ROM Titled 'Atlas of Pathology' for Medical Students.
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Dong Sug Kim, Yong Jin Kim, Sun Woo Park
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Korean J Pathol. 2000;34(5):374-380.
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- The authors have made a CD-ROM titled 'Atlas of Pathology (AP)' for medical students to understand histopathologic findings with ease. We used a 35 mm film scanner to convert an existing file into digital images. A pathologist and two professional programmers collaborated to create the program 'AtlasMaster 1.0' based on (IBM) PC for organization of previously captured digital images. Minimum system requirement for the 'AP' was Pentium II 166 MHz, 32 MB RAM, Windows 95 or 98, 800 600 resolution, 16-bit color, 20 speed CD-ROM drive. The 'AP' was composed of a execution file (Pathology_Atlas.exe), a DB file (pathology.mdb), and reference files (*.bmp, *.jpg, *.txt). The DB file contained fields for chapter, section, disease entity, and information for location of reference files. About 1,000 color images for various kinds of gross and microscopic pictures were stored in the CD-ROM and those were classified according to the chapters, sections, and disease entities. The 'AP' was easy to manipulate, and had advantages of self-learning for students. It could be applied to other fields in which many images were dealt with, such as histology, radiology, endoscopy, dermatology, and plastic surgery. The 'AP' was handy and very useful for medical students to study pathology and it would be a powerful self-learning tool.
- Pseudosarcomatous Metaplastic Carcinoma of the Breast with Extensive Cystic Change: A case report.
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Ji Shin Lee, Jong Jae Jung, Dong Sug Kim
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Korean J Pathol. 2000;34(4):314-317.
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- Metaplastic carcinomas (carcinomas with metaplasia) of the breast are difficult to accurately diagnose and classify because of their rarity and varied histologic patterns. Cystic change can be encountered in mammary carcinoma, especially in carcinoma with squamous metaplasia, but are rare in pseudosarcomatous metaplastic carcinoma. We recently experienced a case of pseduosarcomatous metaplastic carcinoma in a 69-year-old female who had an extensive cystic change in radiologic and histopathologic findings. The precise cell type that gives rise to metaplastic carcinomas remains uncertain.
Immunohistochemical findings raised the possibility of the myoepithelial nature of the tumor.
- Expression of MIB-1 in Endometrial Adenocarcinoma: Correlation with p53 Protein Expression and Histologic Prognostic Factors.
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Mi Jin Kim, Young Ran Shim, Dong Sug Kim
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Korean J Pathol. 1999;33(12):1146-1151.
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- The evaluation of the proliferative potential of malignant neoplasm is of major interest for predicting their biological behavior. MIB-1, a monoclonal antibody against the Ki-67 antigen, is a marker of cell proliferation, which is widely applied to human cancers recently. To assess the growth potential of uterine endometrial carcinoma, we performed immunohistochemical staining of MIB-1 in 34 cases of endometrial adenocarcinoma (endometroid type) from the paraffin sections. We evaluated its correlation with p53 overexpression and known prognostic factors including FIGO grade, nuclear grade, myometrial invasion, and estrogen and progesterone receptors. As a result, the MIB-1 labelling index was significantly correlated with FIGO grade, nuclear grade and myometrial invasion (p<0.05) and there was no significant correlation between MIB-1, ER or PR status. The expression of p53 protein showed significant correlation with FIGO grade and nuclear grade (p<0.05) and there was no significant correlation among p53 protein, myometrial invasion, ER and PR status.
The MIB-1 labelling index revealed striking difference between p53 positive and p53 negative group (p<0.05). We concluded that MIB-1 labelling index is associated with poor prognostic parameter in endometrial adenocarcinoma, and may be a useful marker for predicting tumor of high grade and deep myometrial invasion, if MIB-1 labelling index is more than 50% and is accompanied by p53 overexpression.
- Combined Epithelial-Myoepithelial Carcinoma and Basal Cell Adenocarcinoma of the Parotid Gland: A case report.
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Young Kyung Bae, Dong Sug Kim, Jang Soo Suh, Jae Yun Ro
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Korean J Pathol. 1999;33(6):453-456.
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- Epithelial-myoepithelial carcinoma and basal cell adenocarcinoma are uncommon, low-grade malignant epithelial neoplasms of salivary gland.
They occur predominantly in the parotid glands with frequent recurrences and occasional distant metastases. We report an unusual case of combined epithelial-myoepithelial carcinoma and basal cell adenocarcinoma within the same mass of the parotid gland in a 32-year-old woman. To the best of our knowledge, this is the first such a combined carcinoma case.
- Invasive Micropapillary Carcinoma of the Breast: A clinicopathologic study of 16 cases.
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Young Kyung Bae, Dong Sug Kim, Mi Jin Kim, Soo Jung Lee
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Korean J Pathol. 1999;33(4):267-273.
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- Invasive micropapillary carcinoma is a recently defined unusual variant of invasive breast carcinoma characterized by the formation of micropapillae within clear spaces separated by delicate fibrocollagenous stroma. This study was designed to examine clinicopathologic features of invasive micropapillary carcinoma of the breast. Sixteen cases of invasive micropapillary carcinoma were retrieved from the files of the Department of Pathology, Yeungnam University College of Medicine. We evaluated their clinicopathologic findings including patients' age, tumor size, nuclear grade, vascular invasion, axillary lymph node status, presence of extensive intraductal carcinoma, estrogen and progesterone receptors, p53, c-erbB-2, MIB-1 labelling index and follow-up data and compared this results with those of 292 cases of invasive ductal carcinoma, not otherwise specified. The incidence of invasive micropapillary carcinoma was 4.2% of all invasive breast carcinoma, and the mean age of the patients was 46 years.
Nine cases were pure form (over 75% of micropapillary growth pattern in the tumor) and seven cases were mixed form. The results of clinicopathologic findings, except vascular invasion and axillary lymph node status, of the 16 cases of invasive micropapillary carcinoma were not different from those of the 292 cases of invasive ductal carcinoma, not otherwise specified (p>0.05). However, the rate of vascular invasion and axillary lymph node metastasis was significantly higher in invasive micropapillary carcinoma (p <0.05). Of 16 cases, five cases had distant metastasis during follow-up period, and one patient died of cancer.
Although the mechanism of higher vascular invasion and lymph node metastasis in micropapillary growth pattern could not be determined, we propose that invasive micropapillary carcinoma should be recognized as a separate entity with increased risks of vascular invasion and axillary lymph node metastsis.
- The Significance of Nuclear Size in Nuclear Grade of Invasive Ductal Carcinoma of the Breast.
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Young Kyung Bae, Dong Sug Kim, Hye Jung Choi, Mi Jin Gu, Soo Jung Lee, Jea Young Lee
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Korean J Cytopathol. 1999;10(1):21-26.
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- To make the objective standard of nuclear size in grading nuclear pleomorphism of invasive ductal carcinoma of the breast, we measured maximal nuclear diameter of tumor cells on imprint cytology slides and histologic sections from 65 cases by using computer-based image analysis system(Optimas 6.0). The maximal diameter of red blood cells were also measured to evaluate the ratio of maximal nuclear diameter of tumor cells to maximal diameter of red blood cells. The mean values of maximal nuclear diameter of tumor cells on imprint cytology slides and histologic sections were 7.56 micrometer, 7.53 micrometer in nuclear grade 1, 8.92+/-0.98 micrometer, 9.02+/-0.74 micrometer in nuclear grade 2, and 12.90+/-1.47 micrometer, 12.44+/-1.41 micrometer in nuclear grade 3, respectively.
There were no significant differences between values of imprint cytology and histologic section. The ratio of maximal nuclear diameter of tumor cells to maximal diameter of red blood cells were 1.3-1.4:1 in nuclear grade 1, 1.6-1.7:1 in nuclear grade 2, and 2.2-2.3:1 in nuclear grade 3. These values would be guidelines for grading nuclear pleomorphism of invasive ductal carcinoma of the breast on routine surgical pathology work.
- Expression of bcl-2 and p53 Protein in Primary Gastric Lymphomas.
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Young Rok Cho, Yu Na Kang, Sang Sook Lee, Hong Suk Song, Soo Sang Sohn, Dong Sug Kim
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Korean J Pathol. 1998;32(11):978-984.
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- The bcl-2 gene is a proto-oncogene which extends cell survival by blocking apoptosis. Bcl-2 expression has been detected in many types of nodal and MALT lymphoma. The p53 gene is a tumor suppressor gene and p53 mutation is the most common genetic alteration in human malignancies. The relationship between the expression of bcl-2 and p53 protein in primary gastric lymphoma has been rarely reported. The authors investigated the expression of bcl-2 and p53 protein in 37 cases of primary gastric lymphoma by immunohistochemical method using bcl-2 and p53 monoclonal antibodies. There were five cases of low grade B-cell MALT lymphomas and thirty two cases of high grade B-cell lymphomas. Fifteen of 37 cases (41%) showed bcl-2 protein expression in the cytoplasm of tumor cells and 26 cases (70%) showed p53 protein expression in the nucleus of tumor cells. Bcl-2 protein was detected in 4 of 5 (80%) low grade MALT lymphomas, and in 11 of 32 (34%) high grade lymphomas.
There was no significant correlation between bcl-2 expression and histologic grade of primary gastric lymphomas (p>0.05). p53 protein was positive in 25 of 32 (78%) high grade lymphomas, and in 1 of 5 (20%) low grade MALT lymphomas. The expression of p53 protein is significantly higher in high grade lymphoma than in low grade MALT lymphoma (p<0.05). The p53 expression in the bcl-2 negative cases (86%) was significantly higher than in the bcl-2 positive cases (47%). There was an inverse relationship between bcl-2 and p53 expression in primary gastric lymphoma. These results suggest that bcl-2 and p53 expression in primary gastric lymphoma may be involved in the transition from low grade MALT lymphoma to high grade lymphoma.
- The Diagnostic Significance of AgNORs and MIB-1 Labelling Index in Atypical Meningioma.
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Dae Hong Suh, Dong Sug Kim, Oh Lyong Kim
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Korean J Pathol. 1998;32(11):1008-1014.
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- There is no definite histological criteria which can predict the biologic behavior of meningiomas, although resectability is the most important factor in terms of recurrence. For grading meningiomas, various factors have been studied, such as hypercellularity, nuclear pleomorphism, small cells with high N/C ratio, prominent nucleoli (PN), frequent mitosis, loss of architecture, focal necrosis (FN). We investigated 116 meningiomas to evaluate the correlation between the factors and the proliferative activity using AgNORs and MIB-1 labelling index (LI). They were divided into 3 groups: Group A includes meningiomas with none of the factors; group B with one of the factors; group C with two or more factors.
MIB-1 LI was correlated with each factor, but AgNORs was not. There was a statistical difference among group A (<1.28%), B (2.7%) and C (5.1%) (p<0.05) using MIB-1 LI. FN was the most frequently associated with other factors, and it had the highest MIB-1 LI (6.31%). MIB-1 LI of group B was 5.1 2.3%. In group B, the most frequent combination was FN and PN, and it showed the highest MIB-1 LI (5.74%). This study indicates that FN and PN are important for diagnosis of atypical meningioma, and MIB-1 LI appears to be a useful method for estimating the proliferative activity of meningiomas, and 5% or more of MIB-1 LI could help in making a diagnosis of atypical meningioma.
- Mixed Gangliocytoma-Pituitary Adenoma: A case report.
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Dong Sug Kim, Dae Hong Suh, Mi Jin Kim, O Lyong Kim
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Korean J Pathol. 1998;32(2):138-141.
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- The mixed gangliocytoma-pituitary adenoma is a very rare intracranial neoplasm, and it is frequently associated with endocrine symptoms; acromegaly, Cushing's disease, galactorrhea and amenorrhea. Morphologically it shows a mixture of gangliocytoma and pituitary adenoma in various proportions. In the area of gangliocytoma, there is no neoplastic glial component. The portion of pituitary adenoma consists mainly of chromophobe cells. There are three hypotheses in its histogenesis. We report a case of a 41 year-old lady presented with acromegaly and amenorrhea existing for 3 years. On magnetic resonance image, there is a dumbell-shaped mass in the sellar region. Histologically it showed typical features of mixed gangliocytoma-pituitary adenoma. This case is presented in the view of its rarity and interesting possible histogeneses.
- Tumor Angiogenesis and Cathepsin-D Expression in Invasive Ductal Carcinoma of the Breast.
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Young Gyung Bae, Dae Hong Suh, Dong Sug Kim, Soo Jung Lee
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Korean J Pathol. 1997;31(8):735-744.
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- This study was conducted to assess the prognostic value of tumor angiogenesis and Cathepsin-D in breast carcinoma, by correlating them with other clinicopathologic prognostic factors. In order to estimate microvessels within the tumor, an immunohistochemical method using monoclonal antibodies for factor VIII-related antigens (DAKO-vWf, F8/86) was used, and they were counted (perx200 field) in the most active areas of neovascularization. For the expression of Cathepsin-D, an immunohistochemical method using monoclonal antibodies (Novocastra, NCL-CDm) was performed. The microvessel count ranged from 8 to 346 per x200 field and the mean (+/-SD) was 72.46+/-54.96. The microvessel count was correlated with the estrogen receptor status, and it was also correlated with the tumor size when it was graded into four groups (1-33, 34-67, 68-100, >100), but was not correlated with other clinicopathologic parameters.
Cathepsin-D was expressed in 40% (46/115) of the cases, but it was statistically correlated with the tumor size only. In conclusion, the expression of Cathepsin D and the degree of angiogenesis in breast cancer showed a correlation with the tumor size only. Therefore, they do not appear to be good prognostic parameters, according to the present study.
- Computerization of Microscope Slide Labelling.
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Dong Sug Kim, Dae Hong Suh
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Korean J Pathol. 1997;31(7):628-634.
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- The automation in surgical pathology, particularly in the reporting and encoding system using personal computers has been greatly improved in recent years, but the computerization of microscope slide labelling has not been improved. The authors have developed database program for slide labelling using FoxPro 2.5 and FoxBASE SCOUNIX 2.1.2: For I year during trial an effect has been put forward to simplify and organize the labelling work in routine surgical pathology. The program is now become easily applicable to the labelling work without disturbing the normal flow in a pathology laboratory. It is possible to get information concerning how many paraffin blocks and H&E slides have been made, as well as what kind of special stains have been requested for each case. The authors think that the computerization of labelling work in routine surgical pathology is a fairly easy task, and this should simplify the labelling work at a lower cost, diminish the workload of a typist or technician, and indirect information concerning the workload in a pathology laboratory can be calculated.
- Expression of p53 Protein and c-erbB-2 Oncoprotein in Breast Carcinoma.
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Eun Hee Lee, Dong Sug Kim, Tae Sook Lee, Soo Jung Lee
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Korean J Pathol. 1995;29(5):596-606.
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- This study was conducted to evaluate the expression of p53 and c-erbB-2 using immuno-histochemical methods in 145 primary breast carcinomas and to correlate it with other histo-pathological prognostic factors. Invasive ductal carcinoma represented 129 of the cases. Expression of p53 protein and c-erbB-2 oncoprotein was present in 48% (62/129) and 30% (39/129) of invasive ductal carcinomas, respectively. The expression of p53 protein was stongly associated with a high score of degree of differentiation (p<0.05), nuclear pleomorphism (p<0.05), mitotic index (p<0.05), SBR grade (p<0.05) and MSBR grade (p<0.05), but it was not associated with patient's age, size of tumor or axillary node metastasis. The overexpression of c-erbB-2 C-erbB-2 oncoprotein was strongly associated with a high score of nuclear pleomorphism and a high SBR grade (p<0.05), but not associated with patient's age, size of tumor, axillary node metastasis, degree of differentiation, mitotic index or MSBR grade. An inverse relationship between the expression of p53 protein and estrogen receptor status was found, but the expression of c-erbB-2 was not associated with estrogen receptor status. It is concluded that p53 protein and c-erbB-2 oncoprotein are important prognostic factors in breast cancers, and that the aberrant expression of p53 protein is the most useful prognostic factor becausd of strong association of known histopathological prognostic factors and negative estrogen receptor status.
- The Aberrant Expression of p53 Protein in Liver Cell Carcinoma.
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Woo Young Jang, Dong Sug Kim, Ki Kwon Kim, Tae Sook Lee, Chang Yoon Kim, Hong Jin Kim
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Korean J Pathol. 1995;29(5):607-614.
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- This study was carried out to evaluate the aberrant expression of p53 protein using immunobistochemical method in 54 surgically resected liver cell carcinomas and to correlate it with clinical and pathological findings. Twenty five out of 54 cases(46%) showed positive reaction in the nucleus of liver cell carcinoma and negative reaction in associated 30 cases of cirrhosis, one case of adenoma and two cases of adenomatous hyperplasia. The p53 protein expression was associated with alpha-FP level(p<0.05), but not associated with HBsAg positivity. It was significantly associated with WHO classification, Edmondson-Steiner grade and nuclear grade p53(p<0.05), but not associated with tumor size, capsule formation, portal vein invasion, cirrhosis in surrounding tissue, Eggel classification, special cell type and mitosis. In conclusion, our results suggest that the aberrant expression of p53 protein can be an advisory factor, at least, for prognosis evaluation.
- Secretory Meningioma: Report of 2 cases.
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Dong Sug Kim, Eun Hi Lee, Young Ran Shim, Sang Pyo Kim, Oh Ryong Kim
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Korean J Pathol. 1995;29(3):361-367.
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- The secretary meningioma is a distinct variant of meningioma that revealed characteristic light microscopic, immunohistochemical and ultrastructural features of epithelial and secretary differentiation, which was named as a distinct subtype of meningioma by Alguacil-Garcia et al in 1986. We experienced 2 cases of secretary meningioma. One was a 53-year-old female who had suffered from sudden onset of dizziness for I day. The computerized tomography revealed a sharply marginated well enhanced mass in temporal lobe.
The other was a 59-year-old female who had suffered from dizziness for 8 years. The computerized tomography revealed a well demarcated lobulated mass in petrosal ridge. In both cases, multiple hyaline inclusions were scattered in the background of meningothelial meningioma. They were PAS positive, diastase resistant, stained yellow with van Gieson, and did not stain with reticulin in contrast to Psammoma bodies. The immunohistochemistry revealed positive reaction for EMA, CEA, a-FP and cytokeratin. T'he electron microscopic study revealed interdigitation with desmosomes and abundant intracellular lumina. They were lined by numerous microvilli and filled with granular material which was composed of electron dense homogenous material, me branous material, and small membrane-bound vesicles.
Microvilli were filled with electron dense material identical to the material in the lumina, and some of them were interconnected with electron dense material in the lumina. It was concluded that secretary activity of the meningothelial cells and degenerated microvilli were involved in the pathogenesis of hyaline inclusions.
- Ileal anisakiasis: A report of two cases.
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Young Ran Shim, Dong Sug Kim, Tae Sook Lee
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Korean J Pathol. 1995;29(1):91-95.
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- Anisakiasis is a parasitic disease of the gastrointestinal tract caused by ingestion Of raw or undercooked fish containing the marine nematode larvae belong to the subfamily Anisakinae. The adult worms are intestinal parasites of marine mammals. Eggs are passed in the feces of these mammals and develop to the second stage larvae in the sea water. They are eaten by crustaceans in which the larvae develop to the third stage. When fish or squid eat the infected crustaceans the larvae migrate to the body cavity or the muscle. The infected fish or squid is eaten by marine mammals the larvae attach to the wall of the stomach and then undergo adult worm. In Korea, human anisakiasis is not rare. The clinical manifestations are variable and depend on the involving site of gastrointestinal tract. The frequent sites are stomach and small intestine, and large intestine is rarely involved. Recently we experienced two cases of ileal anisakiasis occurred in 54-year-old female and 46-year-old female patients. The symptoms were upper and lower abdominal pain, nausea, and vomiting. The resected ileums in case I and 2 measured 12.5 x 2.5 cm and 15.0 x 2.0 cm, respectively. The mucosa and submucosa were thickened.
In case 1, submucosal penetration of a white thread-like parasite was seen. The ileum showed submucosal edema, and extensive infiltration of eosinophils, neutrophils, lymphocytes, histiocytes, and plasma cells from mucosa to mesentery with or without mucosal ulceration. The Anisakis larvae are found in the submucosa and propria muscle. They have thick multilayered smooth cuticle, many somatic muscle cells, triradiated esophagus with numerous tall columnar cells, renette cell, and Y-shaped lateral chords.
Reproductive organ is absent. In Korea, the previously reported 14 cases and present 2 cases of the intestinal anisakiasis mainly involved ileum, but the cause was not mentioned.
- p 53 Protein Expression in Imprint Cytology of Breast Carcinoma.
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Dong Sug Kim, Eun Hi Lee, Ki Kwon Kim, Mi Jin Kim, Soo Jung Lee
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Korean J Cytopathol. 1995;6(1):1-9.
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- This study was carried out to determine the usefulness of imprint cytology for detecting p 53 protein in breast carcinoma. NCL-DO7(Novocastra, U.K.) was used to detect p53 protein immunocytochemically. A total of 33 cases was studied. Immunostaining of imprint cytology with NCL-DO7 was positive in 64%(21\33) and showed relatively high coincident rate (80 %) with immunostaining of formalin-fixed, paraffin - embedded specimen. p 53 protein was related to negative estrogen receptor status, but not to the nuclear grade, lymph node metastasis, or tumor size. The fact that p53 protein expression was not related to nuclear grade might be due to predominance of nuclear grade 3. It was easier to determine the nuclear grade is one of the most important prognostic factors, in imprint cytology than in tissue specimen. p53 protein tended to be stained more strongly in imprint cytology than in tissue.
- An Ultrastructural Study on the Small Intestinal Absorptive Cells of Rat after Administration of Lead Acetate.
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Dong Sug Kim, Kee Kwon Kim, Eun Sook Chang
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Korean J Pathol. 1994;28(6):559-568.
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- This study was carried out to visualize lead by Timm sulphide silver method and to define lead-induced change of duodenal absorptive cells of rat after administration of 0.01% lead acetate with drinking water. Sprague-Dawley rats, weighing 250g, were used, and they were orally administered with 0.01% sodium acetate and sacrificed at 0.5, 1, 1.5 hours and 2, 7, 15, 30, 45, 60 days after administration. A portion of duodenal tissue was observed under light microscope, scanning and transmission electron microscopes after development with Danscher method. The blood lead concentration in experimental group began to increase from the 2nd day after administration, and it increased gradually until the 45th day and decreased at the 60th day. On light microscope, many brown lead granules were observed at the villi tip at the 2nd day. There is mild blunting of villi tip at the 45th day. At the 60th day, most of the villi were mildly shortened and showed lymphangiectasia. On scanning electron microscope, the villi tip was mildly blunted and the extrusion zone became irregular at the 45th day. The depth of creases did not change. At the 60th day, the villi tip was moderately blunted and the extrusion zone was markedly irregular. The depth of creases increased. On transmission electron microscope, at 0.5 hour after oral administration, numerous lead granules were diffusely scattered and were not confined to any specific microorganelles. The lead granules decreased with time. At the 7th 15th day, the intercellular spaces were widened and several vacuoles appeared and the condensation of mitochondrial matrix. There was also ribosomal detachment from RER, and there was neither secondary lysosomes or post-lysosomes. At the 30th and 45th day, secondary lysosomes appeared and the condensation of mitochondrial matrix with early formation of myelin figures was noted. At the 60th day, the intercellular space widening extended to the upper most portion of the cells, and nonspeciqic degenerative changes became severe. In view of above mentioned findings, it can be concluded that passive diffusion as well as active transport was partly involved in the absorption of lead. Most of the changes of microorganelle are compatible with nonspecific degenerative changes which could occur due to impairment of oxidative phosphorylation.
- Computerization of Surgical Pathology Reporting by Personal Computer.
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Dong Sug Kim, Young Ran Shim, Mee Jin Kim, Hae Joo Nam, Won Hee Choi, Tae Sook Lee
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Korean J Pathol. 1992;26(2):146-153.
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- The authors have been developed a menu-driven FoxBASE system for surgical pathology reporting and automatic encoding in Systematized Nomenclature of Medicine. The system requires no prior knowledge of FoxBASE and is readily installed on any IBM or it's compatible personal computer. Working sheet generation is automatically accompanied by data from previous cases on the same patient. Important data which include patient name, age, sex, surgical number, hospital unit number and encoded diagnoses, are stored on the hard disk permanently; complete reports are saved on floppy diskettes. Cases can be retrieved by patient name, surgical number, hospital unit number and SNOMED codes within 0.1 second. Daily work lists and listings of incomplete cases are easily obtained. This FoxBASE system has been in use for 1 year and 6 months and resulted in increased efficiency of retrieval and gathering of basic information for specific study, cost effectiveness, markedly diminished workload of typist and very short wasting time during complete restoration of data file for hard disk failure.
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