- Primary Malignant Melanoma of the Urinary Bladder: A Case Report.
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Sung Hak Lee, Eun Deok Chang, Eun Jung Lee, Chang Suk Kang
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Korean J Pathol. 2010;44(2):216-219.
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DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.2.216
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- Primary malignant melanoma in the bladder is very rare, with only 18 cases having been currently reported. A 65-year-old male patient presented with a 5-month history of gross hematuria. On ultrasonography, an 8.1 x 6.1 cm mass was revealed on the bladder wall. A partial cystectomy was performed. Microscopically, the tumor was composed of atypical, pigmented melanocytes that were positive for S-100 protein and they were negative for human melanoma black-45.
Although he underwent supportive therapy, an 8.7 x 5.9 cm mass occupying the prevesical space was noted on a follow-up computed tomography scan 4 months later. Two nodules of the left lower lung and multiple enlarged lymph nodes in the left external iliac chain were also revealed. The patient declined any further treatment. The histogenesis of primary bladder melanoma is uncertain, but an origin from neural crest cells has been proposed. The prognosis for patients with this tumor is still poor despite the availability of several therapeutic options.
- Pneumocystis jirovecii Pneumonia Accompanied with Fat Embolism: A Case Report.
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Sung Hak Lee, Ok Ran Shin, Eun Jung Lee, Kyo Young Lee
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Korean J Pathol. 2009;43(4):355-357.
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DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.4.355
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- Pneumocystis jirovecii is an atypical fungus that causes severe pneumonia in immune compromised patients. While Pneumocystis jirovecii pneumonia (PCP) is more commonly diagnosed in individuals who have HIV infection, it can occur in individuals with other forms of immunosuppression.
Fat embolism most commonly develops after orthopedic injuries, but it has also been reported after other forms of trauma such as severe burns, closed-chest cardiac massage, and liposuction. Overlap in the clinical presentation of these diseases has not yet been reported. We report here on a case of PCP with fat embolism in 52-year-old female patient who had no obvious risk factors for HIV infection.
Even if risk factors for HIV or other forms of immunosuppression are not present, PCP can also be seen in patients who present with fat embolism, and the clinical presentation of both conditions can overlap.
- Expression of Survivin According to Malignant Progression of Breast Lesions.
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Hyun Joo Choi, Ji Han Jung, Chan Kwon Jung, Jinyoung Yoo, Eun Jung Lee, Chang Suk Kang, Seok Jin Kang, Kyo Young Lee
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Korean J Pathol. 2007;41(4):238-243.
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Abstract
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- BACKGROUND
The aim of this study was to examine the survivin expression pattern in benign lesions, atypical ductal hyperplasias (ADH), ductal carcinomas in situ (DCIS) and in invasive carcinomas of the breast and to evaluate the effect of expression of this marker on the malignant progression of breast cancers. In addition, the relationship between the expression of the marker and the clinicopathological characteristics for invasive carcinomas were investigated.
METHODS
Immunohistochemical staining using a tissue microarray method for survivin was performed for 103 benign lesions, 30 ADHs, 26 DCISs and 116 invasive carcinomas.
RESULTS
The expression of cytoplasmic survivin was higher for invasive carcinomas than for ADHs and DCISs (p<0.05).
For breast invasive carcinomas, expression of cytoplasmic survivin significantly correlated with tumor size, lymph node metastasis and stage (p<0.05).
CONCLUSIONS
These results suggest that overexpression of cytoplasmic survivin may be involved in the development of the late stage of breast malignancy, especially invasiveness. In breast invasive carcinomas, expression of survivin may be a useful indicator for the evaluation of patient prognosis.
- S Phase Kinase Associated Protein 2 Expression in Breast Cancer and Its Prognostic Implications.
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Eun Deok Chang, Eun Jung Lee, Se Jeong Oh, Chang Suk Kang
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Korean J Pathol. 2005;39(2):69-73.
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Abstract
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- BACKGROUND
S Phase Kinase Associated Protein 2 (Skp2), an F-box protein necessary for DNA replication, has recently been demonstrated to be an oncogene. The purpose of this study was to examine the Skp2 expression and to investigate its association with expressions of estrogen receptor (ER), androgen receptor (AR) and HER-2, as well as clinicopathological variables including tumor recurrence.
METHODS
The expressions of Skp2, ER and AR were examined by immunohistochemistry and HER-2 amplification by chromogenic in situ hybridization (CISH) in 117 cases of breast carcinoma.
RESULTS
Skp2 was expressed in 26 patients (22.2%) and was significantly correlated with tumor type (p=0.031), tumor grade (p=0.017) and ER expression (p=0.038). Twenty four (20.5%) of 117 patients had a tumor recurrence, and 6 patients (5.1%) died of multifocal metastases. Tumor recurrence was significantly correlated with histological grade (p=0.041) and lymph node status (p<0.001).
CONCLUSIONS
Although Skp2 expression was statistically insignificant in association with tumor recurrence, it might be useful as a biologic predictor in breast cancer. The simple and reliable immunohistochemical assay presented in this study can be a routine part of breast cancer evaluation and may influence patient management.
- E-cadherin Expression in Distinguishing Ductal and Lobular Carcinomas of the Breast.
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Eun Deok Chang, An Hi Lee, Eun Jung Lee, Seok Jin Kang, Chang Suk Kang
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Korean J Pathol. 2002;36(5):323-327.
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Abstract
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- BACKGROUND
Most breast carcinomas are easily categorized as ductal or lobular. However, in some cases the distinction can be difficult since some tumors may have intermediate features of these two. Prior studies suggest that E-cadherin is useful to classify tumors as ductal or lobular, as it is lost in lobular but not in ductal carcinomas.
METHODS
We studied the histologic features and E-cadherin expression by immunohistochemistry in 57 cases of breast carcinomas, which were divided into three groups based on histology. Group 1 included 4 cases of infiltrating lobular carcinoma (IFL) and 1 case of lobular carcinoma in situ (LCIS) (n=5). Group 2 included infiltrating ductal carcinoma (IFD) with some features of IFL (n=48). Group 3 included a solid type of intraductal carcinoma (DCIS) (n=4). E-cadherin staining was scored as negative or positive.
RESULTS
All 5 cases from group 1 were E-cadherin negative, and all 4 DCIS cases were positive. Only 2 (0.04%) of the 48 cases from group 2 were E-cadherin negative.
CONCLUSIONS
Our findings suggest that the majority of cases with morphologically IFD with some IFL features are ductal.
E-cadherin immunostaining is of value in helping to characterize breast carcinomas with indeterminate morphologic features.
- Expression of CD44 Splicing Variants v4/5 and v6 in Gastric Adenocarcinoma and Its Relationship with Prognostic Factors.
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Lee So Maeng, Hae Kyung Lee, Byung Kee Kim, Eun Jung Lee
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Korean J Pathol. 2000;34(2):119-124.
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- CD44, an integral membrane glycoprotein expressed by many cell types, serves as the principal transmembrane hyaluronate receptor and may be a determinant of metastatic and invasive behavior in carcinomas. This study was performed to investigate the relationship between CD44 splicing variants v4/5 and v6 expression and histopathologic prognostic factors (depth of tumor invasion, histologic classification, vascular and lymphatic invasion, and lymph node metastasis) in 107 gastric adenocarcinomas. In 107 cases of gastric carcinoma, the immunohistochemical stainining for CD44 v4/5 and CD44 v6 gave the following results. CD44 v4/5 was expressed in 40.2% and CD44 v6 in 67.3% of gastric carcinomas. The expression of CD44 v4/5 was correlated with histologic classification by Lauren (p<0.05), lymphatic invasion (p<0.05), and lymph node metastasis (p<0.004). In contrast, expression of CD44 v6 had no impact on prognostic markers. This study suggests the role of CD44 v4/5 in invasion, metastasis, and its prognostic significance in gastric adenocarcinoma.
- Chromophobe Renal Cell Carcinoma.
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Yeong Jin Choi, Tae Kon Hwang, Youn Soo Lee, Eun Jung Lee, Seok Jin Kang, Byung Kee Kim, Sang In Shim
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Korean J Pathol. 1999;33(4):259-266.
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- We report 13 chromophobe renal cell carcinomas (10.8%) observed among 120 renal cell carcinomas in adults. The average age was 53 (range: 34-72) years old, and 6 were males and 7 females. The mean tumor size was 10 (range: 5-17) cm, mean nuclear grade 2.4, and mean Robson's stage was 1.9. There were two distinct histologic variants; typical variant (n=9) and eosinophilic variant (n=4). Both of them showed typical light microscopic features and positive reaction with Hale's colloidal iron and carbonic anhydrase II, a marker protein of intercalated cells of renal collecting ducts. A strong positive immunoreactivity for epithelial membrane antigen was noted in the cytoplasm in 12 of 13 tumors. Numerous microvesicles, 180~440 nm in diameter, were identified ultrastructurally. DNA aneuploidy was found in 3 out of 10 cases. Neither local recurrence nor metastasis have been identified during the following period of 4~144 (mean 48) months.
- AgNOR Counts in S-phase Human Cells.
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Seung Il Kim, Eun Jung Lee
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Korean J Pathol. 1999;33(2):103-107.
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Abstract
- The nucleolus of human cell is a morphologically well recognizable nuclear organelle and the argyrophilic NORs (AgNORs) are nucleic acid-argyrophilic nonhistone protein complex in the nucleoli and the silver staining allows their identification and enumeration at the light microscopic level. The AgNOR counts are in parallel with mitotic activity and vary in different phase of cell cycle. It has been reported that human cells have one AgNOR during interphase and S-phase. However, the correlation between the number of AgNORs and S-phase markers is still controversial and they have never been studied simultaneously. In this study, AgNOR and PCNA were stained simultaneously to find out the relationship of AgNOR counts with cell cycle (S-phase) in human palatine tonsil, gastric carcinoma, liver and brain tissues. S-phase cells (PCNA-positive) were found predominantly in lymphoid follicles in palatine tonsil but gastric carcinoma showed diffuse immunoreactivity for PCNA.
The AgNOR counts varied according to the type and locus of tissue. More than one AgNOR were identified in S-phase cells and some of hepatocytes and neurons in the brain which were not in S-phase contained two or more AgNORs. The above results suggest that the number of AgNOR is a characteristic feature of each type of cells and can be more than one even in S-phase.
- Papillary Adenocarcinoma of Nonpigmented Ciliary Epithelium of the Eye.
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Hyun Joo Choi, Yeong Jin Choi, Youn Soo Lee, Eun Jung Lee, Seok Jin Kang, Byung Kee Kim, Sang In Shim
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Korean J Pathol. 1998;32(12):1104-1107.
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Abstract
- Adenocarcinoma of the ciliary epithelium is a rare tumor, usually occuring in elderly patients who have a history of severe ocular trauma or chronic inflammation. We report an adenocarcinoma of the nonpigmented ciliary epithelium found within the phthisical globe of a 36-year-old female whose eye had been loss of vision since infancy. The mass, measured 4.0 x 4.0 cm, was relatively limited by sclera but had invasion to posterior portion. Histologically, the tumor was a compact mass which consisted of tubular and papillary structures with foci of the pleomorphic area. Strands of cells and individual cells were invested with thick basement membrane that have positivity for periodic acid-Schiff stain. Immunohistochemical staining showed strong reactivity for cytokeratin and epithelial membrane antigen, and focal for neuron-specific enolase and S-100 protein.
- Primary Malignant Melanoma of the Esophagus: A case report.
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Lee So Maeng, Kyoung Mee Kim, Eun Jung Lee, Anhi Lee, Sang In Shim
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Korean J Pathol. 1998;32(9):694-696.
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Abstract
- This report presents an unusual case of primary malignant melanoma in the midesophagus. The patient was a 36-year-old woman presenting with dysphagia and odynophagia. The resected esophagus and proximal stomach showed a dark purple large polypoid mass, measuring 6.0 3.3 2.0 cm, with a diffuse tan pigmentation of surrounding mucosa in the mid-esophagus and two small daughter nodules, up to 1.2 0.3 cm, in the lower esophagus near the gastro-esophageal junction. A microscopic examination revealed a malignant melanoma of epithelioid cell type confined to mucosa and submucosa with a diffuse melanosis. Cytoplasmic immunoreactivity for HMB 45 and S-100 protein were noted. An electron microscopic examination revealed large, loosely cohesive variable shaped cells with a few cytoplasmic premelanosomes.
- Normoblasts and Lymphocytes Carry the Fused Bcr-Abl Gene in Chronic Myelogenous Leukemia: Two Color Fluorescence in Situ Hybridization(FISH) Analysis on the Blood Smears.
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Chang Suk Kang, Eun Jung Lee, Won bae Lee, Yong goo Kim, Kyung Ja Han, Kyung Soo Lee, Sang In Shim
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Korean J Pathol. 1998;32(1):58-62.
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- We performed dual color fluorescence in situ hybridization (FISH) for the bcr/abl fusion in CML using the peripheral blood smears without destruction of cell morphology to determine the bcr/abl fusion. Two patients of CML, one patient in accelerated phase and one patient in chronic phase, were selected. The blood smears were fixed in absolute methanol. FISH was performed with the Mbcr/abl translocation DNA probe mixture and the slides were stained with Wright's stain after FISH. The blood smears of both cases revealed distinct signals without destruction of cellular morphology. The normoblasts and lymphocytes revealed beautiful fused bcr/abl signals as well as granulocytes in both cases. The results provide a novel finding that the normoblasts and lymphocytes in CML are also neoplastic clonal cells which has not been demonstrated with a single-cell approach before.
- Primary Teratocarcinoma of the Pineal Gland: A case report.
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Kyoung Mee Kim, Eun Jung Lee, Ki Wha Yang, Anhi Lee, Sang In Shim, Sun Moo Kim
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Korean J Pathol. 1995;29(4):527-529.
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- Teratocarcinoma is a form of mixed germ cell tumor composed of a mixture of teratoma and embryonal carcinoma. It is rarely found in the brain, but when present it is most commonly found in the pineal region. We investigated a case of primary teratocarcinoma in the pineal region. The patient was a 10 year old boy who had suffered from a bitemporal headache for one month. Brain CT and MRI revealed a rather well defined ovoid heterogenous mass in the pineal gland region, measuring 4.3 x 3.8 x 3.0 cm in size.
Microscopically the tumor contained areas of immature teratoma and embryonal carcinoma. Immunohistochemical staining revealed positive reactions for cytokeratin, epithelial membrane antigen, carcinoembryonic antigen, and alpha-fetoprotein in the embryonal carcinoma component.
- Mixed Germ Cell Tumor in Third Ventricle: A report of case.
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Ki Hwa Yang, Sung Dae Jin, Eun Jung Lee, Kyo Young Lee, Seok Jin Gang, Byoung Kee Kim, Sun Moo Kim
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Korean J Pathol. 1988;22(1):118-122.
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- Primary mixed germ cell tumor is a very rare tumor in the cranial cavity. It is composed of varying combination of germ cell neoplasms, such as germinoma, embryonal carcinoma, choriocarcinoma and teratoma. The authors experienced a case of mixed germ cell tumor developing in the floor of the third ventricle, in a twelve years old boy. He was admitted to the hospital, because of headache, eyeball pain, diplopia and vomiting. Brain CAT scan revealed a round tumor density in the floor of the third ventricle. Tumor marker study, preoperatively checked, revealed beta-HCG, 439.8 mIU/ml and alpha-fetoprotein, under 20 ng/ml. On operation, there was a dark brown firm mass up to 3.0 cm in the third ventricle, that invaded into the foramen Monro. With microscopic examination, this tumor is composed chiefly of germinoma, with embryonal carcinomatous region, choriocarcinomatous region and focal mature teratomatous region. The authors diagnosed this case as mixed germ cell tumor.
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