Journal of Pathology and Translational Medicine

Dong Wha Lee

49 Articles

Cytomorphologic Features According to HPV DNA Type in Histologically Proven Cases of the Uterine Cervix.: In Ho Choi, So Young Jin, Dong Wha Lee, Dong Won Kim, Yoon Mi Jeen; Korean J Pathol. 2011;45(6):612-620.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.6.612

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BACKGROUND
This study investigated whether human papillomavirus (HPV) genotype is related to koilocytic changes in cervical cytology and histology, and what factors cause discrepancies among cytology, HPV DNA chip tests, and biopsies.
METHODS
We examined 174 of 949 cases histologically confirmed by both cytology and HPV DNA chip testing. We analyzed koilocytic changes in cytology and biopsies according to HPV genotype.
RESULTS
HPV-16 significantly coincided with nuclear size variation and hyperchromasia, although the cytomorphologic features correlated with other HPV genotypes were not statistically significant. By analyzing 68 cases in which there were discrepancies between the HPV DNA chip test and histological results, we confirmed that artifacts or glycogen acanthosis resulted in the over-diagnoses of four HPV-negative cases with normal cytology. Four diagnostic errors and four sampling errors were present in eight HPV-positive cases. The degree of nuclear size variation significantly influenced the cytologically under-diagnosed cases (p=0.006).
CONCLUSIONS
Other than HPV-16, HPV genotype exhibited no cytological or histological differences. The discrepancy between the results of HPV DNA chip test and histology was created by glycogen acanthosis, immature squamous metaplasia, artifacts, and sampling errors.

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Koilocytic changes are not elicited by human papillomavirus genotypes with higher oncogenic potential
Mitsuaki Okodo, Kaori Okayama, Koji Teruya, Hirokazu Kimura, Natsumi Noji, Yasuyoshi Ishii, Masahiko Fujii, Mizue Oda, Toshiyuki Sasagawa
Journal of Medical Virology.2020; 92(12): 3766. CrossRef
Analysis of Sequence Variation and Risk Association of Human Papillomavirus 52 Variants Circulating in Korea
Youn Jin Choi, Eun Young Ki, Chuqing Zhang, Wendy C. S. Ho, Sung-Jong Lee, Min Jin Jeong, Paul K. S. Chan, Jong Sup Park, Xuefeng Liu
PLOS ONE.2016; 11(12): e0168178. CrossRef
Uncommon and Rare Human Papillomavirus Genotypes Relating to Cervical Carcinomas
Na Rae Kim, Myunghee Kang, Soon Pyo Lee, Hyunchul Kim, Jungsuk An, Dong Hae Chung, Seung Yeon Ha, Hyun Yee Cho
Korean Journal of Pathology.2014; 48(1): 43. CrossRef
Distribution of Human Papillomavirus 52 and 58 Genotypes, and Their Expression of p16 and p53 in Cervical Neoplasia
Tae Eun Kim, Hwal Woong Kim, Kyung Eun Lee
Korean Journal of Pathology.2014; 48(1): 24. CrossRef

WHO Classification of Malignant Lymphomas in Korea: Report of the Third Nationwide Study.: Jin Man Kim, Young Hyeh Ko, Seung Sook Lee, Jooryung Huh, Chang Suk Kang, Chul Woo Kim, Yun Kyung Kang, Jai Hyang Go, Min Kyung Kim, Wan Seop Kim, Yoon Jung Kim, Hyun Jung Kim, Hee Kyung Kim, Jong Hee Nam, Hyung Bae Moon, Chan Kum Park, Tae In Park, Young Ha Oh, Dong Wha Lee, Jong Sil Lee, Juhie Lee, Hyekyung Lee, Sung Chul Lim, Kyu Yun Jang, Hee Kyung Chang, Yoon Kyung Jeon, Hye Ra Jung, Min Sun Cho, Hee Jeong Cha, Suk Jin Choi, Jae Ho Han, Sook Hee Hong, Insun Kim; Korean J Pathol. 2011;45(3):254-260.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.3.254

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Abstract PDF

BACKGROUND
The aim of study was to determine the relative frequency of malignant lymphoma according to World Health Organization (WHO) classification in Korea.
METHODS
A total of 3,998 cases diagnosed at 31 institutes between 2005 and 2006 were enrolled. Information including age, gender, pathologic diagnosis, site of involvement and immunophenotypes were obtained.
RESULTS
The relative frequency of non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL) was 95.4% and 4.6%, respectively. B-cell lymphomas accounted for 77.6% of all NHL, while T/natural killer (T/NK)-cell lymphomas accounted for 22.4%. The most frequent subtypes of NHL were diffuse large B-cell lymphoma (42.7%), extranodal marginal zone B-cell lymphoma (MZBCL) of mucosa-associated lymphoid tissue (19.0%), NK/T-cell lymphoma (6.3%) and peripheral T-cell lymphoma (PTCL), unspecified (6.3%), in decreasing order. The relative frequency of HL was nodular sclerosis (47.4%), mixed cellularity (30.6%), and nodular lymphocyte predominant (12.1%) subtypes. Compared with a previous study in 1998, increase in gastric MZBCL and nodular sclerosis HL, and slight decrease of follicular lymphoma, PTCL, and NK/T-cell lymphoma were observed.
CONCLUSIONS
Korea had lower rates of HL and follicular lymphoma, and higher rates of extranodal NHL, extranodal MZBCL, and NK/T-cell lymphoma of nasal type compared with Western countries. Changes in the relative frequency of lymphoma subtypes are likely ascribed to refined diagnostic criteria and a change in national health care policy.

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Journal of Radiation and Cancer Research.2023;[Epub] CrossRef
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The Korean Journal of Internal Medicine.2023; 38(6): 893. CrossRef
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Clinical course of duodenal mucosa‐associated lymphoid tissue lymphoma: Comparison with gastric mucosa‐associated lymphoid tissue lymphoma
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Leukemia & Lymphoma.2020; 61(4): 808. CrossRef
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Practical Approach to the Histologic Diagnosis of Gastrointestinal Lymphomas Through the First-line Marker Battery of CD20, CD3, CD30, and Epstein-Barr Virus–encoded RNAs
Eun Kyung Kim, Woo Ick Yang, Hyang Joo Ryu, Hee Lee Ji, Sun Och Yoon
Advances in Anatomic Pathology.2020; 27(2): 75. CrossRef
Treatment of mantle cell lymphoma in Asia: a consensus paper from the Asian Lymphoma Study Group
Dok Hyun Yoon, Junning Cao, Tsai-Yun Chen, Koji Izutsu, Seok Jin Kim, Yok Lam Kwong, Tong Yu Lin, Lim Soon Thye, Bing Xu, Deok Hwan Yang, Won Seog Kim
Journal of Hematology & Oncology.2020;[Epub] CrossRef
Morphologic variant of follicular lymphoma reminiscent of hyaline-vascular Castleman disease
Jiwon Koh, Yoon Kyung Jeon
Journal of Pathology and Translational Medicine.2020; 54(3): 253. CrossRef
Discovery of Novel Recurrent Mutations and Clinically Meaningful Subgroups in Nodal Marginal Zone Lymphoma
Jiwon Koh, Insoon Jang, Seongmin Choi, Sehui Kim, Ingeon Jang, Hyun Kyung Ahn, Cheol Lee, Jin Ho Paik, Chul Woo Kim, Megan S. Lim, Kwangsoo Kim, Yoon Kyung Jeon
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Debahuti Mohapatra, Rajashree Tripathy, Prateek Das, Pallak Batalia
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BMC Cancer.2020;[Epub] CrossRef
Extranodal non-Hodgkin’s lymphoma: A case series at a tertiary care hospital
Pomilla Singh, Ravi Swami, Shashank Singh, N S Mani, M N Karandikar
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Heejung Chae, Dok Hyun Yoon
The Korean Journal of Medicine.2019; 94(2): 152. CrossRef
Classification of malignant lymphoma subtypes in Korean patients: a report of the 4th nationwide study
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Phase II study of R–CVP followed by rituximab maintenance therapy for patients with advanced marginal zone lymphoma: consortium for improving survival of lymphoma (CISL) study
Sung Yong Oh, Won Seog Kim, Jin Seok Kim, Seok Jin Kim, Dok Hyun Yoon, Deok‐Hwan Yang, Won Sik Lee, Hyo Jung Kim, Ho‐Young Yhim, Seong Hyun Jeong, Jong Ho Won, Suee Lee, Jee Hyun Kong, Sung‐Nam Lim, Jun Ho Ji, Kyung A. Kwon, Gyeong‐Won Lee, Jae Hoon Lee,
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Changing trends in lymphoid neoplasm distribution in South Korea: analysis of 8615 cases from a single institute, 1997–2016
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Medicine.2019; 98(45): e17641. CrossRef
Non‐Hodgkin lymphoma in South East Asia: An analysis of the histopathology, clinical features, and survival from Thailand
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Hematological Oncology.2018; 36(1): 28. CrossRef
Prevalence and Implications of Bone Marrow Involvement in Patients with Gastric Mucosa-Associated Lymphoid Tissue Lymphoma
Sang Il Choi, Myeong-Cherl Kook, Sanghyun Hwang, Young-Il Kim, Jong Yeul Lee, Chan Gyoo Kim, Il Ju Choi, Hyewon Lee, Hyeon Seok Eom, Soo-Jeong Cho
Gut and Liver.2018; 12(3): 278. CrossRef
A Case of Synchronous Lung Squamous Cell Carcinoma and Diffuse Large B-cell Lymphoma
Seung Jae Lee, Si Young Lim, Tae Kyung Yoo, Seul Ki Kim, You Gyung Kim, Hyun Joo Lee, Jae Uk Song
The Korean Journal of Medicine.2018; 93(3): 300. CrossRef
A risk stratification model for nodal peripheral T-cell lymphomas based on the NCCN-IPI and posttreatment Deauville score
Ho-Young Yhim, Yong Park, Yeon-Hee Han, Sungeun Kim, Sae-Ryung Kang, Joon-Ho Moon, Ju Hye Jeong, Ho-Jin Shin, Keunyoung Kim, Yoon Seok Choi, Kunho Kim, Min Kyoung Kim, Eunjung Kong, Dae Sik Kim, Jae Seon Eo, Ji Hyun Lee, Do-Young Kang, Won Sik Lee, Seok M
European Journal of Nuclear Medicine and Molecular Imaging.2018; 45(13): 2274. CrossRef
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Jaewook Kim, Ji-Hun Lim, Joseph Jeong, Seon-Ho Lee, Jae-Cheol Jo, Sang Hyuk Park
Blood Research.2018; 53(3): 261. CrossRef
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Renata D. Mazaro, Isis P.J. Rizkallah, Flávia S. Luz, Douglas M. Lorensetti, Bruno Cogliati, Rafael A. Fighera
Pesquisa Veterinária Brasileira.2018; 38(9): 1772. CrossRef
Serious fungal infections in Korea
K. Huh, Y. E. Ha, D. W. Denning, K. R. Peck
European Journal of Clinical Microbiology & Infectious Diseases.2017; 36(6): 957. CrossRef
Epidural Lymphoma Mimicking Hematoma: A Case Report
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Journal of Korean Society of Spine Surgery.2017; 24(1): 49. CrossRef
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Mina Ha, Seung-sik Hwang, Sungchan Kang, No-Wook Park, Byung-Uck Chang, Yongjae Kim
International Journal of Environmental Research and Public Health.2017; 14(4): 344. CrossRef
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Radiation Oncology Journal.2017; 35(3): 249. CrossRef
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Oncotarget.2017; 8(54): 92289. CrossRef
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Korean Pediatric/Adolescent Lymphoma: Incidence and Pathologic Characteristics.: Seung Sook Lee, Jin Man Kim, Young Hyeh Ko, Jooryung Huh, Chang Suk Kang, Chul Woo Kim, Yun Kyung Kang, Jai Hyang Go, Min Kyung Kim, Wan Seop Kim, Yoon Jung Kim, Hyun Jung Kim, Hee Kyung Kim, Jong Hee Nam, Hyung Bae Moon, Chan Kum Park, Tae In Park, Young Ha Oh, Dong Wha Lee, Jong Sil Lee, Juhie Lee, Hyekyung Lee, Sung Chul Lim, Kyu Yun Jang, Hee Kyung Chang, Yoon Kyung Jeon, Hye Ra Jung, Min Sun Cho, Hee Jeong Cha, Suk Jin Choi, Jae Ho Han, Sook Hee Hong, Insun Kim; Korean J Pathol. 2010;44(2):117-124.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.2.117

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Abstract PDF

BACKGROUND
The Hematopathology Study Group of the Korean Society of Pathologists conducted a nation-wide retrospective analysis of Korean pediatric lymphoma, to provide pathologic data on pediatric/adolescent lymphoma subtypes and features.
METHODS
All lymphoma cases of all age groups were collected during a recent 2 year-period (2005-2006) from 32 institutes in Korea. Among 3,686 lymphoma patients, 142 who were age 18 or less were classified according to the World Health Organization (WHO) classification.
RESULTS
Among 142 pediatric/adolescent lymphoma patients, Hodgkin lymphoma accounted for 21 (14.8%) and non-Hodgkin lymphoma (NHL) for 121 (85.2%). Hodgkin lymphoma appears to be more common in the pediatric/adolescent age group than in the all-ages group (14.8% vs 4.4%). T- and natural killer cell-NHL was more common in the pediatric/adolescent age group than in the all ages group (46.3% vs 22%). The majority of Korean pediatric/adolescent NHL cases was composed of Burkitt lymphoma, T- or B-lymphoblastic lymphoma, anaplastic large-cell lymphoma, and diffuse large B-cell lymphoma. For lymphoma patients under the age of 6 years, most had B-lymphoblastic or Burkitt lymphoma, which commonly presented at extranodal sites.
CONCLUSIONS
The distribution of lymphoma subtypes in the pediatric/adolescent age group is quite different from the distribution of adults, but it was quite similar to distribution in Western countries.

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A Case of Nasal Type Extranodal NK/T Cell Lymphoma Incidentally Detected in a Child
Ha Jin Oh, Sang Hyun Park, Hae In Jang, Dong Hoon Lee, Yoo Duk Choi, Hee Jo Baek, Hoon Kook
Clinical Pediatric Hematology-Oncology.2015; 22(1): 76. CrossRef

Diagnostic Accuracy of Cervicovaginal Cytology in the Detection of Squamous Epithelial Lesions of the Uterine Cervix; Cytologic/Histologic Correlation of 481 Cases.: So Young Jin, Sang Mo Park, Mee Sun Kim, Yoon Mi Jeen, Dong Won Kim, Dong Wha Lee; Korean J Cytopathol. 2008;19(2):111-118.; DOI: https://doi.org/10.3338/kjc.2008.19.2.111

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Abstract PDF

BACKGROUND
Cervicovaginal cytology is a screening test of uterine cervical cancer. The sensitivity of cervicovaginal cytology is less than 50%, but studies of cytologic/histologic correlation are limited. We analyzed the diagnostic accuracy of cervicovaginal cytology in the detection of the squamous epithelial lesions of the uterine cervix and investigate the cause of diagnostic discordance. MATERIALS AND METHODS: We collected a total of 481 sets of cervicovaginal cytology and biopsies over 5 years. The cytologic diagnoses were categorized based on The Bethesda System and the histologic diagnoses were classified as negative, flat condyloma, cervical intraepithelial neoplasia (CIN) I, CIN II, CIN III, or squamous cell carcinoma. Cytohistologic discrepancies were reviewed.
RESULTS
The concordance rate between the cytological and the histological diagnosis was 79.0%. The sensitivity and specificity of cervicovaginal cytology were 80.6% and 92.6%, respectively. Its positive predictive value and negative predictive value were 93.7% and 77.7%, respectively. The false negative rate was 19.4%. Among 54 false negative cytology cases, they were confirmed by histology as 50 flat condylomas, 2 CIN I, 1 CIN III, and 1 squamous cell carcinoma. The causes of false negative cytology were sampling errors in 75.6% and interpretation errors in 24.4%. The false positive rate was 7.4%. Among 15 false positive cytology cases, they were confirmed by histology as 12 atypical squamous cells of undetermined significance (ASCUS) and 3 low grade squamous intraepithelial lesions (LSIL). The cause of error was interpretation error in all cases. The overall diagnostic accuracy of cervicovaginal cytology was 85.7%.
CONCLUSIONS
Cervicovaginal cytology shows high overall diagnostic accuracy and is a useful primary screen of uterine cervical cancer.

Citations

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Overall accuracy of cervical cytology and clinicopathological significance of LSIL cells in ASC‐H cytology
S. H. Kim, J. M. Lee, H. G. Yun, U. S. Park, S. U. Hwang, J.‐S. Pyo, J. H. Sohn
Cytopathology.2017; 28(1): 16. CrossRef
Correlation Analysis Between Cervicovaginal Cytologic and Histopathologic Diagnoses in Cervical Squamous Cell Neoplasm
Kyoung Bun Lee, Woon Sun Park, Jin Hee Sohn, Min Kyung Kim, Dong Hoon Kim, Hee Sung Kim, Seoung Wan Chae, Sung Hee Kang, Young Hye Cho, Hee Dae Pak, Sun Hee Kim
The Korean Journal of Pathology.2009; 43(2): 157. CrossRef

A Case of Gastric Inverted Hyperplastic Polyp Associated with Gastritis Cystica Profunda and Early Gastric Carcinoma.: Min Sung Choi, So Young Jin, Dong Won Kim, Dong Wha Lee, Sang Mo Park; Korean J Pathol. 2007;41(1):55-58.

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Abstract PDF: A gastric inverted hyperplastic polyp is characterized by downward growth of the hyperplastic mucosal components into the submucosa. Lesions are composed of hyperplastic foveolar-type glands, and sometimes coexist with gastritis cystica profunda (GCP). Adenocarcinoma frequen- tly can coexist, but the relationship is not clear. A 71-year-old male was admitted to hospital because of dyspepsia for one month. He underwent a wedge resection of the stomach, after endoscopic biopsies. The gross finding showed a slightly elevated papillary lesion with central depression. Microscopically, the elevated lesion was composed of hyperplastic fundic glands and foveolar cells, and the central depressed lesion showed a nodular inverted proliferation of normal appearing gastric epithelium and glands in the submucosa. An additional proximal gastrectomy specimen exhibited marked GCP and a minute adenocarcinoma at the proximal margin with p53 protein overexpression.

A Sertoli-Leydig Cell Tumor in a Patient with Complete Androgen Insensitivity Syndrome: A Case Report.: Min Sung Choi, Dong Won Kim, So Young Jin, Sang Mo Park, Dong Wha Lee; Korean J Pathol. 2007;41(1):59-62.

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Abstract PDF: Complete androgen insensitivity syndrome (CAIS) is a rare disorder sometimes referred to as male pseudohermaphroditism. This syndrome is characterized by a 46,XY karyotype with internal bilateral testes, female external genitalia, absence or scantiness of pubic and axillary hair and normal breast development. A variety of gonadal tumors can develop in individuals with CAIS. A 57-year-old patient was admitted to urology with intermittent gross hematuria for one month. CT revealed a left ureteric mass, measuring 2.5 x 2 cm. Ureteroscopic biopsy was performed and the result was a diagnosis of high grade urothelial carcinoma. The patient underwent laparotomy which revealed slightly enlarged gonads in the pelvic cavity. However, a uterus and fallopian tubes were not identified. Left nephroureterectomy and bilateral gonadectomy were performed. The right gonad measured 3.9 x 2.5 x 2 cm and the cut surface showed a well circumscribed, firm, brownish gray colored 2 x 1.8 cm sized nodule. Microscopically, this nodule consisted of uniform and solid tubules containing immature Sertoli cells and Leydig cells which were both positive for alpha-inhibin. The left gonad measured 3.5 x 2 x 1.9 cm and showed atrophic testicular tissue.

ISUP/WHO Classification of Papillary Urothelial Neoplasms of Urinary Bladder: Consensus Study Conducted by Korean Society of Urogenital Pathology.: Jung Weon Shim, Jae Y Ro, Nam Hoon Cho, Young Sik Kim, Yong Wook Park, Sang In Shim, Dong Wha Lee, Yeong Jin Choi, Woon Sup Han; Korean J Pathol. 2006;40(4):282-288.

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Abstract PDF: BACKGROUND
Pathologic grading, one of the most important prognostic factors of papillary urothelial neoplasia (PUN) of the urinary bladder, has been revised continuously. The current study focused on the analysis of interobserver agreement on PUN of the urinary bladder bet- ween 1973 WHO classification (WHO 1973) and 1998 WHO/ISUP classification.
METHODS
Seventy five cases from 15 institutions were collected, and after review by Korean Society of Urogenital Pathology (KSUP), 30 cases were selected as follows; group I, WHO grade 1 and papillary urothelial neoplasm of low malignant potential by ISUP (7 cases), group II, WHO grade 2 and low-grade papillary urothelial carcinoma (16 cases), and group III, WHO grade 3 and high-grade papillary urothelial carcinoma (7 cases). Seventy five general surgical pathologists who participated in this study were asked to grade the tumors based on WHO/ISUP classification. Interobserver agreement between the participants' diagnosis and KSUP consensus diagnosis was analyzed by kappa value.
RESULTS
Interobserver agreement assessed by kappa value for all diagnostic groups was very low; for group I, kappa value was -0.900893722; for group II, -0.944650025, and for group III, -0.876728996. The overall kappa value of pathology residents was better than that of practicing pathologists.
CONCLUSIONS
The 1998 WHO/ ISUP classification could not be easily translated from the 1973 WHO classification and because of poor interobserver agreement, it appears that further work would be needed before it can be practically applied.

Utility of Bile Duct Brush Cytology in Pancreaticobiliary Diseases: Prospective Comparative Study of Conventional Smear and MonoPrep2(TM) Liquid Based Cytology.: So Young Jin, Dong Wha Lee, Mee Sun Kim, Young Deok Cho, Young Koog Cheon, Min Sung Choi, Dong Won Kim; Korean J Cytopathol. 2006;17(1):38-45.

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Abstract PDF: Bile duct brush cytology has been employed as a diagnostic tool for the evaluation of pancreatic and biliary tract strictures. The specificity of this method is high however, its sensitivity is quite low. A recent study employing liquid based cytology (LBC) reported results comparable to those achieved via conventional cytology. Therefore, we have attempted to prospectively evaluate the diagnostic utility of bile duct brush cytology in pancreaticobiliary diseases. A total of 46 cases with bile duct stricture were enrolled including 11 cases of benign stricture, 29 cases of bile duct carcinoma, 3 cases of gallbladder cancer, and 3 cases of pancreatic cancer. Both conventional smear and LBC using MonoPrep2(TM) system were conducted in each case. The cytological diagnosis of each case was classed into the following categories; benign, suspicious for malignancy, and malignancy. The diagnostic accuracy of both cytologic methods was investigated. LBC evidenced a high rate of material insufficiency (13/46), which was attributed to low cellularity. The kappa index of both cytological methods was 0.508. Cytological and tissue diagnoses were correlated in 25 cases conducted from biopsy or operation. The sensitivity, specificity, positive predictive value, and negative predictive value were 41.2% (7/17), 100% (8/8), 100% (7/7), and 44.4% (10/18) in conventional smear; 58.8% (10/17), 87.5% (7/8), 90.9% (10/11), and 50.0% (7/14) in LBC; and 94.1% (16/17), 87.5% (7/8), 94.1% (16/17), and 87.5% (7/8) in any one of both cytological methods, respectively. Based on these results, the sensitivity of LBC was found to be superior to that of conventional smear and we were able to obtain higher positive predictive value upto 94.1% by simultaneously conducting both cytologic methods.

Fine Needle Aspiration Cytology of Mucoepidermoid Carcinoma of the Peripheral Lung: A Case Report.: Min Sung Choi, So Young Jin, Dong Won Kim, Dong Wha Lee; Korean J Cytopathol. 2005;16(1):36-40.

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Abstract PDF: The mucoepidermoid carcinoma is a rare tumor in the lung for less than 1% of all pulmonary neoplasm. It is mostly presented as a solitary pulmonary nodule at a large bronchial tree on bronchoscope. But more peripheral located tumor that not accessible to the bronchoscope are rarely reported on literature. The cytologic findings of these tumors are discribed as a mixture of squamous cells, mucous cells, and intermediate cells with overlapped cellular clusters. We experienced a case of peripheral mucoepidermoid carcinoma of lung diagnosed by fine needle aspiration cytology. The smear showed many cellular clusters on mucoid background. They consisted of many intermediate cells with occasional mucus-secreting cells, but malignant squamous cells were not present.

Expression of MMP-2, MT1-MMP, and TIMP-2 mRNA in Breast Carcinomas.: Dong Won Kim, So Young Jin, Dong Wha Lee; Korean J Pathol. 2003;37(6):400-406.

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Abstract PDF: BACKGROUND
The activation of proMMP-2 is induced by membrane type 1-matrix metalloproteinase (MT1-MMP), but inhibited by tissue inhibitors of matrix metalloproteinase type 2 (TIMP-2). This study was carried out to establish the pattern of mRNA expression of MMP-2, MT1-MMP, and TIMP-2 in breast carcinomas.
METHODS
Seventy-nine cases of invasive ductal carcinoma, 10 of ductal carcinoma in situ, and 10 of fibrocystic disease as a control were analysed for the expression of MMP-2, MT1-MMP, and TIMP-2 mRNA, using in situ hybridization. Correlations of the results with the clinical stage, tumor size, nodal status, and nuclear grade were analysed.
RESULTS
The expression rates of MMP-2, MT1-MMP, and TIMP-2 mRNA in invasive ductal carcinoma were 68%, 73%, and 56%, respectively. They were localized to both stromal and tumor cells, but mainly in the latter. The MMP-2 mRNA expression was significantly correlated with the clinical stage (p < 0.05), while the expression of TIMP-2 mRNA was inversely correlated with clinical stage and tumor size(p < 0.05). Significant positive correlations between MMP-2 and MT1-MMP expressions, along with inverse relationships between MMP-2 and TIMP-2, and between TIMP-2 and MT1-MMP, were also found. CONCLUSIONS: MMP-2 and TIMP-2 mRNA expressions might be useful as one of a range of prognostic parameters in breast carcinoma patients.

Fine Needle Aspiration Cytology of Biphasic Synovial Sarcoma: A Case Report.: Hee Kyung Kim, So Young Jin, Dong Wha Lee; Korean J Cytopathol. 2003;14(2):96-101.

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Abstract: Synovial sarcoma is a rare soft tissue tumor accounting for 5-10% of soft tissue sarcomas. Most arise in the extremities and trunk, and a small proportion occur in the abdominal wall, head and neck region, and mediastinum. It manifests different phenotypic subtypes that render their cytologic evaluation challenging. Moreover, cytomorphologic description of the epithelial component of synovial sarcoma is rare in Korea. We report a case of biphasic synovial sarcoma on the right lower extremity in a 49-year-old woman diagnosed by fine needle aspiration cytology. The aspirate was moderately cellular and composed of a mixture of tissue fragments and dissociated cells with bland chromatin, inconspicuous nucleoli, and oval to spindle-shaped cytoplasm. Mitosis was rare. A monolayer sheet of epithelial component was seen. The cells in this monolayer sheet had more abundant distinct cytoplasm, round nuclei, and prominent micronucleoli. Histologic examination showed a biphasic pattern consisting of mostly sarcomatous stroma and a few small glandular areas at the periphery of the tumor.

Fine Needle Aspiration Cytology of Ganglioneuroma: A Case Report.: Hee Kyung Kim, Dong Wha Lee, So Young Jin; Korean J Cytopathol. 2003;14(1):12-16.

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Abstract PDF: Ganglioneuroma is a well-differentiated, benign tumor of the sympathetic nervous system. These tumors belong to a family of neoplasm that exhibit a wide range of differentiation, with neuroblastoma at one end and ganglioneuroma at the other. Because it share morphologic features with other both benign and malignant neural tumors, accurate preoperative diagnosis is often difficult. Nonetheless, it is critical for proper management. Fine needle aspiration cytology(FNAC) in the diagnosis of the ganglioneuroma has been a little documented. We describe a case of mediastinal ganglioneuroma in a 33-month-old girl. The diagnosis was suggested on FNAC and was confirmed by histopathologic examination later.

Ki-67 Labelling Index and Bax Expression According to the Capsular Invasion in the Follicular Neoplasms of the Thyroid.: Hee Kyung Kim, Dong Wha Lee, So Young Jin, Dong Won Kim; Korean J Pathol. 2001;35(6):531-535.

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Abstract: BACKGROUND
There have been a few studies concerning the differential diagnosis between follicular adenomas and minimally invasive follicular carcinomas, but it is difficult to exclude the possibility of minute capsular and/or vascular invasion throughout the capsular areas as a whole.
METHODS
We examined the diagnostic usefulness of Ki-67 labelling index and bax expression for the differential diagnosis of follicular adenomas and minimally invasive follicular carcinomas.
RESULTS
The result of immunohistochemical staining with Ki-67 and bax antibodies were analyzed in 58 cases of follicular neoplasms from 1996 to 1999. Of 58 cases, 35 were follicular adenomas and 23 were minimally invasive follicular carcinomas. The Ki-67 labelling index was significantly higher in minimally invasive follicular carcinoma of the thyroid (Ki-67 labelling index, 1.62+/-0.35%) than follicular adenoma (0.46+/-0.21%) (P<0.05). Of the follicular adenomas, Ki-67 labelling index of the tumor with 5 cm or more in diameter was 0.38+/-0.13%, while that of the tumor with less than 5 cm was 0.51+/-0.24%. Of the minimally invasive follicular carcinoma, Ki-67 labelling index of the tumor with 5 cm more was 1.30+/-0.07%, while that of the tumor with less than 5 cm was 1.65+/-0.37%. Diffuse bax expression was seen in 27 of 35 cases of follicular adenomas and 2 of 23 cases of minimally invasive follicular carcinoma (P<0.05).
CONCLUSIONS
Our findings suggest Ki-67 labelling index and the degree of bax expression are useful markers for the differential diagnosis between the follicular adenoma and the minimally invasive follicular carcinoma of the thyroid.

Expression of Matrix Metalloproteinase (MMP)-1, MMP-3 Nitrotyrosine and Apoptosis in Articular Cartilage of Human Osteoarthritis.: So Young Jin, Seong Su Kang, Dong Wha Lee, Soo Jae Yim, Yeo Hon Yun, Byung Ill Lee; Korean J Pathol. 2001;35(4):319-329.

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Abstract PDF: BACKGROUND
Matrix metalloproteinase (MMP)-1 and 3 are the most important degradating enzymes of the chondroid matrix. Chondrocytes may undergo apoptosis under various stimuli including nitric oxide (NO). We studied the expression rate and zone of MMP-1, MMP-3, nitrotyrosine, a marker of NO release, and apoptosis in the articular cartilage of human osteoarthritis.
METHODS
To investigate the role of nitrotyrosine and apoptosis in the degradation of the chondroid matrix in human osteoarthritis, immunohistochemistry was done for MMP-1, MMP-3, and nitrotyrosine; and the terminal deoxynucleotidyl transferase mediated nick end labeling (TUNEL) method was performed for apoptosis using a total of 93 articular cartilages from 12 femoral heads and 17 knees obtained from total joint arthroplasty and 7 normal articular cartilages. RESULTS: In the normal control group, the expression rates for MMP-1, MMP-3, nitrotyrosine, and apoptosis were very low; and their expression zones were confined to the superficial layer of the articular cartilage. Their expression rates were low in the early stage of osteoarthritis and were moderate to high in the late stage (P<0.05). Their expression zones were confined to the superficial layer of the articular cartilage in the early stage of osteoarthritis and were expressed throughout the whole layer in the late stage and those of MMP-3 and nitrotyrosine were statistically significant (P<0.05). Their expression rates and zones were significantly correlated with the grade of osteoarthritis (P<0.05). Conclusion : The expression rate and zone of apoptosis and nitrotyrosine correlated well with those of MMP-1 and MMP-3. Therefore, NO and apoptosis may be related to the progression of human osteoarthritis.

Fine Needle Aspiration Cytology of Solid Papillary Carcinoma of the Breast: Report of a case associated with mucinous carcinoma.: Hee Kyung Kim, Dong Won Kim, So Young Jin, Dong Wha Lee; Korean J Cytopathol. 2001;12(2):127-130.

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Abstract PDF: Solid papillary carcinoma of the breast is a distinctive form of intraductal papillary carcinoma frequently associated with both mucinous carcinoma and infiltrating ductal carcinoma, not otherwise specific. To our knowledge, this case is the first description of the cytologic aspects of solid papillary carcinoma of the breast in the Korean literature. We experienced a case of solid papillary carcinoma of the right breast diagnosed by fine needle aspiration cytology(FNAC) in a 70-year-old female. FNAC from the right breast showed high cellularity consisting of mostly tight clusters of tumor cells and a few scattered tumor cells. The nuclei were monotonously round to oval in shape with inconspicuous nucleoli. The cytoplasm was abundant and finely granular. Scant amount of mucinous material was present on the background. The diagnosis was confirmed histologically and immunohistochemically.

Plasminogen Activator Inhibitor-1, c-erbB2, and p53 Protein Overexpression and Prognosis in Gastric Adenocarcinoma.: Ayoung Park, So Young Jin, Dong Won Kim, Dong Wha Lee; Korean J Pathol. 2000;34(8):559-566.

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Abstract PDF: Despite its fall in incidence, gastric adenocarcinoma remains a common disease with dismal prognosis worldwide. A better understanding of its tumorigenesis and biologic properties of tumor cells related to invasion and metastasis is crucial to improving diagnosis and treatment. Conflicting results concerning the relationships between overexpression of PAI-1, c-erbB2, and p53 protein and biologic behavior of gastric carcinoma have been noted. The aim of this study was to evaluate the value of overexpression of PAI-1, c-erbB2, and p53 protein as prognostic factors in gastric adenocarcinoma. Overexpression of PAI-1, c-erbB2, and p53 protein by immunohistochemistry was correlated with variable clinicopathological parameters and patients' survival in 80 cases of gastric adenocarcinoma. Overall PAI-1 expression rate was 63.7% (51/80) and higher in advanced cancer (p=0.0003) and nodal metastasis (p=0.003) groups. Overall c-erbB2 expression rate was 43.8% (35/80) and higher in antral (p=0.03), differentiated (p=0.001), intestinal (p=0.0007), and expanding (0.03) groups. The p53 protein overexpression was 37.5% (30/80) and higher in early cancer (p=0.02), differentiated (p=0.006) and intestinal groups (p=0.009). Patients with PAI-1, c-erbB2, and p53 protein positive tumors tended to have poorer survival rates than patients with PAI-1, c-erbB2, and p53 protein negative tumors, but the difference was not statistically significant (p=0.25, 0.37, 0.52). Our data indicated that PAI-1 overexpression is one of the poor prognostic factors in gastric adenocarcinoma and c-erbB2 and p53 protein seem to be involved in the early stage of carcinogenesis of intestinal type-gastric adenocarcinoma.

Fine Needle Aspiration Cytology of the Salivary Gland: An analysis of 221 cases .: Ayoung Park, Hee Kyoung Kim, Dong Won Kim, So Young Jin, Dong Wha Lee; Korean J Cytopathol. 1999;10(2):133-143.

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Abstract PDF: Fine needle aspiration cytology of the salivary lesions was performed on 221 patients at Soonchunhyang University Hospital for 10 years. Of 221 aspirates, 6 aspirates(2.7%) were inadequate, 116 cases(52.5%) were non-neoplastic lesions, 76(34.4%) cases were benign neoplasms and 23 cases(10.4%) were malignant neoplasms. The cytologic diagnoses could be correlated with histologic findings in 58 cases. FNAC correctly discriminated between neoplastic and nonneoplastic lesions in fifty-seven lesions and failed in a case, and overall accuracy, sensitivity, and specificity were 98.3%, 98.0%, and 100.0%. FNAC correctly discriminated malignant neoplasms from benign neoplastic/non- neoplastic lesions in fifty-three cases and failed in five cases, and overall accuracy, sensitivity, and specificity were 91.3%, 72.7%, and 95.7%. Among three false negative cases, two mucoepidermoid carcinomas were misdiagnosed as mucocele and benign neoplasm, and an acinic cell carcinoma were misdiagnosed as Warthin's tumor. Two false positive cases were a Warthin's tumor misdiagnosed as squamous cell carcinoma and a pleomorphic adenoma misinterpretated as suggestive of malignancy. In conclusion, diagnostic accuracy of FNAC of salivary lesions is high, and the possibilities of low grade mucoepidermoid carcinoma and acinic cell carcinoma should be considered on hypocellular smears with mucoid or fluidy background.

Fine Needle Aspiration Cytology of Myositis Ossificans: A Case Report.: Dong Won Kim, Dong Wha Lee; Korean J Cytopathol. 1998;9(1):123-128.

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Abstract PDF: The aspiration cytologic finding of myositis ossificans is not well documented but similar to that seen in nodular fasciitis except less cellularity. Myositis ossificans is a reactive condition that is sometimes mistaken microscopically for extraosseous osteosarcoma. Cytologically, myositis ossificans may be distinguished from extraosseous osteosarcoma by the presence of uniform benign stromal cells composed of mature fibroblasts and osteoclastic giant cells. However, the differential diagnosis may be difficult in the early stage of this reactive and proliferative process. We recently experienced a case of myositis ossificans. The patient was a 67-year-old woman with painful swelling of the left index finger for one month. Simple x-ray finding showed a soft tissue mass with calcific center at middle phalanx of the left hand. Fine needle aspiration cytology revealed a few individual or clusters of spindle cells in dense eosinophilic stroma with osteoclastic giant cells. The spindle cells were uniform, smooth-bordered, and oval nuclei with single small inconspicuous nucleoli, and elongated cytoplasm. The scattered individual cells had eccentric nuclei with one or two nucleoli and abundant, basophilic cytoplasm.

Fine Needle Aspiration Cytology of Salivary Duct Carcinoma: A Case Report.: A Young Park, Hyun Jung Kim, Dong Won Kim, Dong Wha Lee; Korean J Cytopathol. 1997;8(2):143-149.

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Abstract PDF: PURPOSE: To investigate renal toxicity of high-dose intravenous immunoglobulin(IVIG) in children with Kawasaki disease and idiopathic thrombocytopenic purpura. METHODS: 23 children with Kawasaki disease and 7 children with idiopathic thrombocytopenic purpura who were treated with high-dose IVIG(2 g/kg) were evaluated for the change of urine output, blood urea nitrogen(BUN), serum creatinine(Scr), creatinine clearance(Ccr), tubular reabsorption of phosphorus(TRP), fractional excretion of sodium(FENa), 24hour urine b2-microg1obuin/creatinine(b2MG/cr) ratio and urine microalbumin/creatinine(MA/cr) ratio at post-IVIG 1 and 3 day. RESULTS: There was no significant change of urine output, BUN, Scr, Ccr, TRP, 24hour urine b2MG/cr and MA/cr ratio after high-dose IVIG treatment. Transient increase of FENa at post-IVIG 1 day was the only significant change.
CONCLUSION
There was no significant renal toxicity of high-dose IVIG in children with Kawasaki disease and idiopathic thrombocytopenic purpura who had normal renal function.

Fine Needle Aspiration Cytology of Matrix Producing Carcinoma of the Breast.: Hyun Jung Kim, Ayoung Park, Dong Won Kim, Dong Wha Lee, Kui Hyang Kwon; Korean J Cytopathol. 1997;8(2):174-178.

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Abstract PDF: Matrix producing carcinoma of the breast is a variant of heterologous metaplastic carcinoma which is defined as "overt carcinoma with direct transition to a cartilagenous and/or osseous stromal matrix without an intervening spindle cell zone or osteoclastic cells". This tumor is very rare, occuring in less than 0.2% of total breast carcinoma, but the prognosis is better than other metaplastic carcinoma. We experienced a case of fine needle aspiration(FNA) cytologic finding of matrix producing carcinoma of the breast. A 75-year old woman, who presented a right huge breast mass(9x8cm) during 10months, was examined. Mammography reveals right lateral mass with even density without calcification. Breast ultrasonography shows multifocal hypoechogenic cystic change in the huge mass, suggesting resolving hematoma or carcinoma or sarcoma with necrosis. On cytologic finding of FNA, myxoid matrix was the dominant feature and the rest of the material was composed of scanty isolated atypical cells with large irregular nuclei. The histologic finding was moderately differentiated adenocarcinoma with abundant cartilagenous matrix and focal squamous metaplasia.

Diagnostic Usefulness of Fine Needle Aspiration Cytology on Lymphadenopathy: An analysis of 1,216 Cases .: Dong Won Kim, So Young Jin, Dong Wha Lee, Chan Soo Lee; Korean J Cytopathol. 1997;8(1):11-19.

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Abstract PDF: Clinical lymphadenopathies are subjected to fine needle aspiration cytology(FNAC) for diagnosing not only benign lesions but also malignant ones, as the first diagnostic procedure. While the diagnostic reliability in metastatic carcinoma is high, it is difficult to differentiate malignant lymphoma from reactive conditions. We evaluated the diagnostic reliability of FNAC in lymphadenopathy, and discuss the diagnostic limitation and its place in clinical practice in this study. Over 8 years from January 1988, FNAC of 1,216 lymphadenopathies were analyzed and among them 170 cases were compared with histopathology. The results are as follows. 1. Of all the cases, 890 cases(73.2%) were diagnosed cytologically as benign, 312 cases(25.7%) as malignant, and 14 cases(1.1%) as unsatisfactory material. Reactive hyperplasia was diagnosed in 585 cases(65.7%) of the benign lesions, and among the malignant diseases, metastatic carcinoma was diagnosed in 248 cases(79.5%), and malignant lymphoma in 62 cases(19.9%). 2. The overall diagnostic accuracy was 89.2%, and no false positive case and 9 false negative results were observed among 170 cases which were proven by histopathology. Six cases of sampling error of false negative diagnoses included 3 of metastatic carcinomas and 3 of malignant lymphomas. The causes were difference between aspiration and biopsy site, poor fixation, or scanty cellularity with bloody smear. All 3 cases of misinterpretation error were malignant lymphomas, one of mixed type on biopsy which was diagnosed as reactive hyperplasia cytologically. In summary, FNAC technique is thought to be useful in the initial diagnosis of lymphadenopathies as well as in the follow-up of patients with known malignancy. Although the results of malignant lymphoma was less accurate than other malignant lesions, the application of strict cytologic criteria or lymphoid marker studies of aspiration material will reduce the false negative rate.

Pneumocystis carinii Pneumonia Presented as Diffuse Alveolar Damage: Report of a case.: Sook Kim, Jeong Ja Kwak, Dong Won Kim, So Young Jin, Dong Wha Lee; Korean J Pathol. 1996;30(12):1155-1158.

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Abstract PDF: Pneumocystis carinii is the most common cause of diffuse pulmonary infiltrates in the immunocompromised patients. Microscopically, Pneumocystis carinii pneumonia(PCP) shows characteristic frothy intraalveolar exudate and interstitial lymphocytic and plasma cell infiltrate. However, sometimes the only histologic finding of PCP on routine hematoxylin-eosin stain is that of diffuse alveolar damage(DAD), when we can miss the diagnosis without aid of special stains. We report a case of Pneumocystis carinii pneumonia presenting as DAD in a 50-year old man after chemotherapy due to malignant lymphoma. Open lung biopsy specimen reveals the early stage of DAD without any characteristic findings, such as foamy exudate. However many cysts of Pneumocystis carinii were found on Gomori's methenamine silver(GMS) stain. Therefore, GMS stain should be routinely performed on all biopsy specimens obtained from immunocompromised patients.

A Histologic Classification of Diffuse Interstitial Lung Disease and Its Clinical Significance.: Eun Suk Koh, Dong Wha Lee, So Young Jin, Sang Ho Cho; Korean J Pathol. 1996;30(11):998-1010.

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Abstract PDF: Diffuse interstitial lung disease(DILD) is a large group of heterogeneous diseases that diffusely involve the pulmonary connective tissues, principally subpleural, interlobular and alveolar wall portions. Terminology and classification of these diseases are not uniform, and the cause and the pathogenesis are unknown in many entities. It is generally accepted that the response to therapy is related to the relative degree of cellularity and fibrosis present, therefore a histologic evaluation of the relative extent and severity of these changes is required. We reviewed 52 cases of DILD from January 1990 to May 1995 diagnosed by open lung biopsy to reappraise classification and quantitative assessment of the histopathologic features. Differential histopathologic features between usual interstitial pneumonia(UIP) and nonspecific interstitial pneumonia(NIP) were examined with a correlation of HRCT findings and clinical findings. Among 52 cases of DILD, 18 cases(34.6%) were UIP, 6 cases(11.5%) were hypersensitivity pneumonia was NIP was 5 cases(9.6%), interstitial lung diseases associated with the connective tissue diseases were 5 cases(9.6%), inorganic dusts were 4 cases(7.7%), infections were 4 cases(7.7%), durgs were 2 cases(3.8%), acute interstitial pneumonia was 1 case(1.9%), sarcoidosis was 1 case(1.9%) in order of frequency plus 6 other cases(11.5%). UIP was the most frequent DILD in this study which seemed to be a criteria bias of patient selection on open lung biopsy. Quantitative assessment of histopathologic features was useful in the differential diagnosis of DILD and differentiation of UIP from NIP was possible based on histopathologic features and supported by HRCT. UIP disclosed a significantly high score of fibrotic changes, especially in the interstitial fibrosis, smooth muscle proliferation and honeycombing, otherwise NIP appeared relatively high score in inflammatory changes. Correlation between histopathologic scores and the clinical outcome after steroid therapy or no therapy in UIP was not evident.

Adenoid Basal Carcinoma Associated with Invasive Squamous Cell Carcinoma of Uterine Cervix: A case report.: Hyun Jung Kim, Dong Won Kim, So Young Jin, Dong Wha Lee; Korean J Pathol. 1996;30(8):739-741.

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Abstract PDF: Adenoid basal carcinoma of the uterine cervix is a rare neoplasm that accounts for less than 1% of cervical adenocarcinomas. Though it has been confused with adenoid cystic carcinoma, it is now distinctly recognized by better prognosis and different histologic and immunohistochemical findings. We have experienced a case of adenoid basal carcinoma associated with invasive squamous cell carcinoma of the uterine cervix in a 52-year-old woman. The tumor was composed of small, round to oval nests of basaloid cells with peripheral palisading. Some of the nests showed central cystic spaces, or cribriform pattern, and central squamous differentiation with cytological atypia. Invasive squamous cell carcinoma was located adjacent to the adenoid basal carcinoma without any transition between these two lesions. Immunohistochemically, the tumor cells disclosed positive staining for cytokeratin, but negative reaction for CEA, EMA, and S-100 protein.

Galactocele in a Male Child: A case report.: Yoon Mi Jeen, Yoon Jeong Choi, Dong Wha Lee, Chan Il Park; Korean J Pathol. 1996;30(2):164-165.

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Abstract PDF: We investigated a unilocular mammary cyst occurring in a two and a half year old male baby. The cyst was lined by simple columnar epithelium and filled with a milky secretory material. These histologic features were consistent with galactocele. The child had enlarged left breast since birth, but it seemed to be noncontributory as the child had neither endocrine abnormalities nor perinatal disorders. Galactocele is an uncommon breast lesion usually occuring in females following lactation. It is rarely a cause of breast enlargement.

A Study of Usefulness of Fine Needle Aspiration Cytology of the Thyroid Lesions.: Kye Hyun Kwon, So Young Jin, Dong Wha Lee; Korean J Cytopathol. 1996;7(2):111-121.

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Abstract PDF: Fine needle aspiration cytology(FNAC) is preferred because of simplicity, safety, and reliability in the evaluation of patients with thyroid nodule or hyperplasia. However, there are a few limitations such as false-negative or false-positive cases and nondiagnostic material. To evaluate the usefulness of FNAC in thyroid lesions, we reviewed 704 FNAC cases of thyroid nodules from 1988 to 1994 at Soonchunhyang University Hospital. The results are as follows. 1. Among 704 FNAC cases of thyroid gland, 571(81.1%) cases were benign, 12 (1.7%0) were suspicious, 71(10.1%0) were malignancy, and 50(7.1%)-were material insufficiency. The cytologic diagnoses of the benign lesions included 168 cases of follicular neoplasm, 139 cases of adenomatous goiter, 162 cases of follicular lesion such as follicular neoplasm or adenomatous goiter, 61 cases of Hashimoto's thyroiditis, 13 cases of subacute thyroiditis, and 28 cases of colloidal nodule or benign nodule. The malignant lesions included 68 cases of papillary carcinoma, two medullary carcinomas and a case of metastatic colon cancer. 2. The average number of cytologic smear slides was 4.12+/-1.81 in material insufficiency and 5.63+/-1.79 in diagnostic cases. This difference was statistically significant(p<0.00001). 3. Histological assessment of 150 cases revealed 2 false negative and 1 false positive cases. The false negative cases were a case of marked sclerosis in papillary carcinoma and an occult case of papillary, carcinoma. The false positive case resulted from pseudo-ground glass nuclei due to marked dry artifact. 4. Comparison between the FNAC and the histologic diagnosis revealed that INAC had a sensitivity of 93.5%, a specificity of 99.2%, a false negative rate of 64%, a false positive rate of 0.8%, and an overall diagnostic accuracy of 98.0%. Therefore, FNAC of thyroid gland is a very reliable diagnostic method with excellent accuracy rate.

Ovarian Mucinous Adenocarcinoma Associated with Mucinous Adenocarcinoma of the Uterine Cervix.: Kye Hyun Kwon, Jeong Ja Kwak, So Young Jin, Dong Wha Lee; Korean J Pathol. 1995;29(2):244-247.

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Abstract PDF: When coexistence of carcinoma with similar histologic type is present in female genital tract, it is difficult to differentiate independent primary tumor from metastasis. Most of them are endometrial and ovarian tumors, but coexistence of uterine cervical and ovarian tumor with similar histologic type is rare. We experienced an independent primary tumor of ovarian mucinous cystadenocarcinoma associated with mucinous adenocarcinoma of uterine cervix. The patient was a 50-year-old woman. She had a lower abdominal mass which was detected as a huge cyst on ultrasonography. Although the ovarian lesions were bilateral, features that preferred to consider independent primary tumor are listed as; absence of lymphatic or vascular invasion, absence of ovarian surface implant, superficial invasion of cervical tumor, absence of tumor in abdominal cavity, and disease free follow-up after removal of the tumor.

A Cytopathologic Analysis of Percutaneous Transthoracic Needle Aspiration Cytology of the Lung: A Six-year Correlation Study in 322 Cases.: Sook Kim, Dong Won Kim, So Young Jin, Dong Wha Lee; Korean J Cytopathol. 1995;6(2):140-147.

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Abstract PDF: In a six-year period (from May 1988 to April 1994), fine needle aspiration cytology (FNAC) of 322 pulmonary lesions from 296 patients were performed at Soonchunhyang University Hospital. Of these 322, malignancy was diagnosed cytologically in 139 (43.2%), suspicious malignancy in 7 (2.2%), negative in 164 (50.8%), and insufficient material in 12 (3.8%). Malignant lesion consisted of 54 cases of adenocarcinoma, 50 cases of squamous cell carcinoma, 18 cases of small cell carcinoma. They were verified by histologic confirmation in 70 cases. There were 2 (0.6%) false positive cases due to florid bronchoalveolar hyperplasia and atypical bronchial epithelial cells associated with granulomatous lesion. Overall accuracy rate was 90%, the sensitivity 84.3% and the specificity 94.7%.

Localized Pseudopolyposis of the Ascending Colon Associated with Granulomatous Colitis: A case report.: Jeong Ja Kwak, Kye Hyun Kwon, So Young Jin, Dong Wha Lee; Korean J Pathol. 1994;28(1):82-85.

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Abstract PDF: Pseudopolyps represent discrete areas of mucosal inflammation and regeneration that are seen in a variety of inflammatory bowel disease including ulcerative colitis and Crohn's disease. These polyps are typically short, measuring less than 1.5 cm in height. Rarely, localized giant pseudopolyposis can occur, i.e., a collection of larger inflammatory pseudopolyps giving rise to a mass lesion within the colon. The most serious problem concerned with pseudopolyposis is a confusion with carcinoma. We experienced a case of localized giant pseudopolyposis causing partial large bowel obstruction. Right hemicolectomy was done for a preoperative diagnosis of ascending colon carcinoma. The resected specimen contained a circumferential lesion, which was composed of numerous interconnecting cylindrical villi, measuring 12 cm in length and 3 cm in height. Microscopically, these polypoid lesions were inflammatory pseudopolyps. Several deep fissure-like ulcerations were noted with multifocal microabscess, lymphoid hyperplasia and an area of noncaseating granuloma.

Fine Needle Aspiration Cytology of Metastatic Adenocarcinoma of Thyroid Gland from the Colon: Report of A case.: Sook Kim, So Young Jin, Dong Wha Lee; Korean J Cytopathol. 1994;5(1):41-45.

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Abstract PDF: Most common metastatic tumors of the thyroid gland are squamous cell carcinoma of head and neck region, adenocarcinoma of breast and lung, malignant melanoma, and renal cell carcinoma of kidney in order of frequency. Metastasis from gastrointestinal tract to the thyroid gland rarely occurs. We experienced a case of fine needle aspiraton cytology of metastatic adenocarcinoma of both thyroid glands from the colon. Cytologic smears showed picket-fence like arrangement of nuclei of carcinoma cells and syncytial type of tissue fragments with acinar pattern on necrotic or mucoid background.

Fine Needle Aspiration Cytology of Chondroblastoma Arising in the Rib: Report of A Case.: Kye Hyun Kwon, So Young Jin, Dong Wha Lee; Korean J Cytopathol. 1994;5(1):61-64.

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Abstract PDF: Chondroblastoma is a benign bone tumor accounting for less than 1% of bone tumor. It infrequently involves the flat bones, among which ribs are particularly rare. On fine needle aspiration cytology, the diagnostic smear consists of chondroblasts, osteoclast-like giant cells, and chondroid matrix. The cytologic hallmark to differentiate from other giant cell-containing lesions is chondroblasts.

Peutz-Jeghers Syndrome with Extensive Epithelial Misplacements and Adenomatous and Carcinomatous Transformation: A case report.: Jeong Ja Kwak, So Young Jin, Dong Wha Lee; Korean J Pathol. 1993;27(6):630-637.

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Abstract PDF: Peutz-Jeghers syndrome is an autosomal dominant disease characterized by gastrointestinal ployposis and mucocutaneous melanin pigmentation involving the lip, oral mucosa, digits, palms and soles. The polyps are almost hamartomatous. The relationship of gastrointestinal carcinoma and the Peutz-Jeghers syndrome has been discussed for many years. The question is unsettled whether gastrointestinal carcinoma arise in hamartomatous polyps itself. Recently, there are a few reports that adenomatous and carcinomatous changes were superimposed upon the background of the hamartoma. Occasionally epithelial misplacement of the epithelium is found in the small intestinal polyps. Since the epithelial misplacement may involve submucosa, muscularis propria and serosa, a difficulty of histopathologic differential diagnosis between the epithelial misplacement and invasive adenocarcinoma cause overdiagnosis of cancer in the gastrointestinal polyps of Peutz-Jeghers syndrome. We present a case of Peutz-Jeghers syndrome of 39-year-old woman with multiple gastrointestinal polyps, two of which showed extensive epithelial misplacement even into the pancreas and another one at the colon showed carcinomatous change at the tip portion. Areas of hamartoma, adenoma and in situ carcinoma were noted in this colonic hamartomatous polyp. This case support that adenoma and carcinomatous changes may evolve directly within a hamartomaous polyp itself.

Fine needle aspiration cytology of Ki-1 positive large cell lymphoma-a case report-.: Kye Hyun Kwon, Jeong Ja Kwak, So Young Jin, Dong Wha Lee; Korean J Cytopathol. 1993;4(2):127-132.

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Abstract PDF: No abstract available.

Fine needle aspiration cytology of langerhans cell histiocytosis.: Jeong Ja Kwak, So Young Jin, Dong Wha Lee; Korean J Cytopathol. 1993;4(2):140-145.

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Abstract PDF: No abstract available.

A study of diagnostic value on fine needle aspiration cytology of the breast masses.: Dong Won Kim, Dong Wha Lee; Korean J Cytopathol. 1993;4(1):1-8.

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Abstract PDF: No abstract available.

Sebaceous Gland Tumor Arising in Cystic Teratoma of the Ovary: An unique form of monodermal teratoma.: Dae Joong Kim, So Young Jin, Dong Wha Lee; Korean J Pathol. 1992;26(1):82-87.

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Abstract PDF: Although cystic teratoma is the most common benign tumor of the ovary, the association of sebaceous gland tumor with cystic teratoma is rare. We have recently experienced a case of sebaceous gland tumor, arising in the cystic teratoma of the ovary in a 78-year-old Korean woman. Histologically, the tumor was characterized by an organoid lobular architectures of the sebaceous glands which are exculsively composed of germinative and mature sebaceous cells. Although it is difficult to come to a valid conclusion due to the presence of atypical mitosis and necrosis, this tumor was regarded as benign from the viewpoint of preserved organoid structures, and absence of capsular invasion or metastasis.

Electron microscopic study on fine needle aspiration cytology of metastatic malignant melanoma.: Dong Wha Lee, So Young Jin, Kye Hyun Kwon; Korean J Cytopathol. 1992;3(2):82-89.

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Abstract: No abstract available.

Fine needle aspiration cytology of apocrine carcinoma of the breast: two cases report-.: So Young Jin, Dong Wha Lee, Jeong Ja Kwak; Korean J Cytopathol. 1992;3(2):67-74.

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Abstract PDF: No abstract available.

Adenoid cystic carcinoma of the breast: diagnosis by fine needle aspiration cytology.: Dong Wha Lee, So Young Jin, Dae Joong Kim, Kui Hyang Kwon; Korean J Cytopathol. 1991;2(2):160-167.

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Abstract PDF: No abstract available.

Pelvic actinomycosis: a case report.: Dae Joong Kim, So Young Jin, Dong Wha Lee; Korean J Cytopathol. 1991;2(2):172-178.

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Abstract PDF: No abstract available.

Adenoid Cystic Carcinoma of the Esophagus: Report of a case with brief review of the literature.: Eun Suk Koh, In Sook Kim, Tae Jung Kwon, Dong Wha Lee, Chan Sup Shim, Kihl Rho Lee; Korean J Pathol. 1990;24(4):482-488.

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Abstract PDF: Adenoid cystic carcinoma of the esophagus is a rare tumor and has been considered to be counterpart of the salivery gland. The patient we experienced was a 60-year-old female who had a tumor in the lower third of the esophagus. The tumor was located in the submucosa and showed histologic features similar to those of the salivary gland. Electron micrsopic examination revealed ductal structures invested by basal lamina, and clusters of basaloid cells with tonofilaments and desmosomes. No myoepithelial cells were identified. Immunohistochemical studies for S-100 protein, cytokeratin and vimentin were performed. A few cells showed positive reaction to the S-100 protein. These findings suggest that the esophageal adenoid cystic carcinoma arises from the duct of submucosal gland.

Three Cases of Neuroblastoma in Adults: Electromicroscopic study.: In Sook Kim, Tae Jung Kwon, Dong Wha Lee; Korean J Pathol. 1990;24(2):153-160.

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Abstract PDF: Because neuroblastoma is predominantly a tumor of childhood, patholgists and clinicians tend to exclude it from differential diagnosis when the patient is an adult. The diagnosis of neuroblastoma by light microscopy can be difficult because of similarities between neuroblasts and cells of other round cell neoplasms. The fine structural features of neuroblastoma is distinctive and is valuable in its diagnosis. We present 2 cases of neuroblastoma and a case of ganglioneuroblastoma arising in adults with their ultrastructural findings.

Fine Needle Aspiration Cytology in the Diagnosis of Tuberculosis.: Dong Wha Lee, So Young Jin, Eun Suk Koh, Chung Ja Kwak; Korean J Cytopathol. 1990;1(1):68-73.

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Abstract PDF: A total 48 cases of tuberculous lesion in the lymph nodes(43 cases), lung (3 cases) and soft tissue(2 cases), was subjected to fine needle aspiration cytology(FNAC). The age of the patients ranged from 19 to 77 year-old(average 33.6 years in age) and the male to female ratio was 1:4. Thirty-four cases (70.8%) demonstrated distinct granulomatous reaction with or without caseastion necrosis, nine cases(18.8%) showed no granulomas, but large amount of necrotic debris with numerous polymorphonuclear cells and histiocytes, and five cases (10.4%) revealed acellular material only. The overall AFB positivity in smears was 62.5%. In areas associated with granulomatous reaction and necrosis, AFB positivity was 55.8%, while it was 80.0% in cases with acellular necrotic material. There were 2 cases of parasitic infestation which could not be easily differentiated from tuberculosis based on aspiration smears only.

Congenital Subglottic Stenosis of the Larynx Associated with Tracheoesophageal Fistula: 1 autopsy case.: In Sook Kim, Tae Jung Kwon, Dong Wha Lee; Korean J Pathol. 1989;23(3):350-354.

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Abstract PDF: Congenital subglottic stenosis of the larynx is one of the most common cause of chronic airway obstruction im infancy and childhood. It is defined as narrowing of the space bounded inferiorly by the inferior margin of the cricoid cartilage amd superiorly by the insertion of the fibers of the conus elasticus into the true vocal cords. In case we experienced was a female full-term baby delivered by Cesarean section. The stenosis was believed by hypertrophy of stromal soft tissue and cricoid cartilage in the subglottic area. The lesion was associated with tracheoesophageal fistula of H1 type. A brief review of the literature was done.

A Case of Desmoplastic Fibroma of the Mandible.: Dong Won Kim, Tae Jung Kwon, Dong Wha Lee; Korean J Pathol. 1988;22(3):340-347.

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Abstract PDF: A case of desmoplastic fibroma of mandible in a 18 years old woman is presented. She had complained progressive swelling of right mandible for 4 years. Radiographically, a multilocular radiolucent of right hemimandibulectomy showed multinodular external surface without cortical destruction. Cut surfaces revealed grayish white, fibrous homogeneous appearance with firm consistency, sparing head portion. The maximum diameter of the tumor was 13 cm. Microscopically, the tumor was composed of interlacing bundles of monomorphic spindle-shaped cells with abundant intercellular collagen. Ultrastructurally, most tumor cells were fibroblastic-like cells with abundant RER and cytoplasmic fibrils, but a few disclosed transition to myofibroblasts. However, no fully developed myofibroblasts were seen.

Malignant Mixed Mesodermal Tumors of Ovary: 3 cases report.: Dong Won Kim, Tae Jung Kwon, Dong Wha Lee; Korean J Pathol. 1988;22(2):169-179.

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Abstract PDF: Malignant mixed mesodermal tumor (MMMT) of the ovary is endometrioid tumor containing epithelial and mesenchymal components. The mesenchymal component may be homologous, in which case the term carcinosarcoma is often used, or heterologous, containing cartilage, striated muscle, osteoid, bone, or fat, or combination of these elements. MMMT usually afflicts the postmenopausal woman and occurs more often in the nulliparous female. The disease is usually advanced (stage III) when diagnosed. Cliniopathologic data were presented for 3 cases of MMMT of the ovary with review of literatures. Clinical history substantiated previous reports in postmenopausal women wit this tumor. Symptoms were the same as for ovarian malignancy in general. All the patients presented wit stage II disease, according to the International Federation fo Gynecology and Obstetrics (FIGO) classification. Two patients died of tumor 4 and 10 months after operation, respectively. One patient had been alive at 2 months after operation. None of 3 cases demonstrate evidence of endometriosis in the remaining ovaries. Microscopically, periodic acid-Schiff (PAS)-positive, diastase-resistant hyaline droplets were found frequently in undifferentiated mesenchymal stroma and epithelial structures. The clinical significance and origin of the hyaline droplets in MMMT should be further explored.

Ultrastructure of 2 Malignant Fibrous Histiocytomas with Reference to the Histogenesis.: Tae Jung Kwon, Keum Min Park, Dong Wha Lee; Korean J Pathol. 1986;20(4):475-483.

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Abstract PDF: Electron microscopic study of two malignant fibrous histiocytomas confirmed the presence of previously described tumor cells in the literature. In addition, there existed intermediate cells with morphologic features of both myofibroblasts and histiocytes, or both histiocytes and smooth muscle cells. Our result supported the idea that malignant fibrous histiocytoma may be derived from the undifferentiated mesenchymal cells that differentiate primarily along a fibroblastic and histiocytic cells.

Embryoral Rhabdomyosarcoma of the Biliary Tree: A case report.: Keum Min Park, Dong Wha Lee, Duk Yong Kang; Korean J Pathol. 1986;20(2):203-208.

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Abstract PDF: Although embryonal rhabdomyosarcoma has been frequently reported in genitourinary tract, head and neck, embryonal rhabdomyosarcoma of the biliary tree is an extremely rarte. It must be considered in differential diagnosis of jaundice in childhood. About 35 cases have been reported in world literatures, since first description on 1875, by Moxon and Wilks. We present a case of embryonal rhabdomyosarcoma of the biliary tree in a 25 months old boy with brief review of literatures. Since chief complaints of this case were jaundice and loss of appetite, the first clinical diagnosis was infectious hepatitis. On ultrasound examination, there is a space occupying lesion in right lobe of liver and it was diagnosed as hepatoma. Choledochoduodenostomy with biopsy was done. The operation revealed dilated common bile dut and both hepatic ducts which were filled with light brown jelly like materials and diagnosed as embryonal rhabdomyosarcoma on frozen and permanent senions. In gross and histologic characteristics, this tumor resembles embryonal rhabdomyosarcoma(sarcoma botryoides) in other locations. In spite of chemo-and radiotherapy after operation, the boy was died.

Juvenile Breast Carcinoma: A case report.: Keum Min Park, Dong Wha Lee, Duk Yong Kang; Korean J Cytopathol. 1985;19(4):438-441.

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Abstract PDF: Breast carcinoma has been infrequently reported in children. About 25 cases have been reported in world literatures since first description in 1913, by Bryan. We present a case of juvenile breast carcinoma in a 17 months old girl with brief review of literatures. Grossly, the submitted specimen is grayish white and measured by 1.3x1.0x0.8 cm in size. It is not encapsulated and its cut surfaces are homogeneous. Microscopic examination showed a neoplastic proliferation of duct cells forming mainly glandular spaces with focal papillary pattern, solid sheets or cribriform pattern. The glandular spaces were filled with collections of PAS-positive eosinophilic secretory materials. The individual cell varied from columnar to polygonal and showed moderate hyperchromatism and variation of nuclear size. Mitoses and necrosis are not found. Tumor cell invasion into the stroma was found.

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