Journal of Pathology and Translational Medicine

Eunsil Yu

19 Articles

Idiopathic Duct Centric Pancreatitis in Korea: A Clinicopathological Study of 14 Cases.: Hyo Jeong Kang, Tae Jun Song, Eunsil Yu, Jihun Kim; Korean J Pathol. 2011;45(5):491-497.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.5.491

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Abstract PDF: BACKGROUND
Idiopathic duct centric pancreatitis (IDCP) is a subtype of autoimmune pancreatitis (AIP) that is histologically characterized by granulocytic epithelial lesion and scarce IgG4-positive cells. This subtype of AIP has not been documented in Asian countries.
METHODS
We reviewed 38 histologically confirmed AIP cases and classified them into lymphoplasmacytic sclerosing pancreatitis (LPSP) and IDCP. Then, clinicopathological characteristics were compared between LPSP and IDCP.
RESULTS
Fourteen cases (36.8%) were IDCP. IDCP affected younger patients more than LPSP. IDCP was associated with ulcerative colitis in 35.7% of cases, whereas LPSP was associated with IgG4-related sclerosing diseases such as cholangitis, retroperitoneal fibrosis or sialadenitis in 41.7% of cases. IDCP was microscopically characterized by neutrophilic ductoacinitis with occasional granulocytic epithelial lesions, whereas LPSP was characterized by storiform inflammatory cell-rich fibrosis and obliterative phlebitis. IgG4-positive cells were not detected in any IDCP case but more than 20 IgG4-positive cells per high-power-field were invariably detected in LPSP cases. All patients with IDCP responded dramatically to steroids without recurrence, whereas 33.3% of patients with LPSP developed recurrences.
CONCLUSIONS
IDCP is clinicopathologically distinct from LPSP and can be diagnosed when neutrophilic ductoacinitis or granulocytic epithelial lesions are observed in a pancreatic biopsy under the appropriate clinical setting.

Clinicopathologic Analysis of the Liver Explant with Severe Hepatitis A Virus Infection.: Joo Young Kim, Sung Gyu Lee, Shin Hwang, Ji Hoon Kim, Se Jin Jang, Eunsil Yu; Korean J Pathol. 2011;45:S48-S52.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.S1.S48

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Abstract PDF: The incidence of severe hepatitis A virus (HAV) infection has been increasing. However, clinicopathologic features of severe HAV infection that lead to liver transplantation (LT) have not been reported in Korea. We retrieved 16 LT cases with HAV infection during the last 3 years at Asan Medical Center, Seoul, Korea. Fifteen cases progressed to hepatic encephalopathy. Thirteen cases survived with or without complications, and three patients died of sepsis. The explanted liver showed massive or zonal necrosis with moderate to severe cholestasis. The zonal distribution of necrosis was frequently associated with endothelialitis of portal and/or central veins. Degenerative changes of hepatocytes were various in degree and distribution. Viral inclusions were suspected in two cases. Although HAV infection is usually confirmed by serological tests, significant venulitis of central and/or portal veins and viral inclusions, which are rarely observed, can suggest an HAV infection as a cause of massive hepatic necrosis of unknown mechanism.

Clinical Outcome of Surgically Resected Pancreatic Intraductal Papillary Mucinous Neoplasm According to the Marginal Status: A Single Center Experience.: Sun A Kim, Eunsil Yu, Song Cheol Kim, Jihun Kim; Korean J Pathol. 2010;44(4):410-419.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.4.410

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Abstract PDF

BACKGROUND
Surgical resection is the treatment of choice of intraductal papillary mucinous neoplasm (IPMN) of the pancreas. However, the benefit of clearing resection margin is still controversial.
METHODS
We reviewed 281 surgically resected cases of IPMN. The recurrences were compared according to the histologic grade (benign or borderline IPMN, malignant noninvasive IPMN, invasive carcinoma) and size (pancreatic intraepithelial neoplasia, PanIN, less than 0.5 cm in the long axis; and IPMN, greater than or equal to 0.5 cm) of the residual lesions at the resection margin.
RESULTS
Sixty cases (21.4%) were invasive carcinoma, and 221 (78.6%) noninvasive cases included 87 (31.0%) benign, 107 (38.1%) borderline and 11 (3.9%) malignant noninvasive IPMN cases. In noninvasive IPMN, increased recurrence in patients with five or more years of follow-up was only related to the involvement of resection margin by severe dysplasia. The recurrence of invasive carcinoma was high (27.3%) even when the resection margin was clear, and was not related to the grade or size of residual tumors at the resection margin.
CONCLUSIONS
Invasiveness is a strong risk factor for recurrence in IPMN regardless of the status of the resection margin. However, in noninvasive IPMN, histologic grading of residual lesions at the resection margin predicts local recurrence.

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Systematic review of challenging issues in pathology of intraductal papillary mucinous neoplasms
Laura D. Wood, N. Volkan Adsay, Olca Basturk, Lodewijk A.A. Brosens, Noriyoshi Fukushima, Seung-Mo Hong, Sung-Joo Kim, Jae W. Lee, Claudio Luchini, Michaël Noë, Martha B. Pitman, Aldo Scarpa, Aatur D. Singhi, Mariko Tanaka, Toru Furukawa
Pancreatology.2023; 23(7): 878. CrossRef
The Use of Intraoperative Frozen Sections in Guiding the Extent of Pancreatic Resections for Intraductal Papillary Mucinous Neoplasms
Zhikai Chi, Deepti Dhall, Richard Mertens
Pancreas.2022; 51(1): 63. CrossRef
Recurrence of non-invasive intraductal papillary municious neoplasm seven years following total pancreatectomy
Nayima M. Clermont Dejean, Sinziana Dumitra, Jeffrey S. Barkun
International Journal of Surgery Case Reports.2013; 4(9): 789. CrossRef

Characterization of Histopathological Features that Differentiate Hepatitis B Virus Infection from Acute Cellular Rejection.: Dong Eun Song, Dong Hwan Jung, Shin Hwang, Bong Hee Park, Eunsil Yu; Korean J Pathol. 2009;43(6):535-541.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.6.535

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Abstract PDF

BACKGROUND
Differentiation of viral hepatitis from acute cellular rejection (ACR) after liver transplantation can be difficult because of overlapping histological features. Here we investigated clinicopathologic characteristics of 311 liver allograft biopsies and searched for characteristic histopathological features that would facilitate the differential diagnosis between hepatitis B virus (HBV) infection and ACR. METHODS: A retrospective clinicopathologic examination of 311 liver allograft biopsies consisting of clinically proven ACR or HBV infection was performed. Immunohistochemical staining for HBcAg and HBsAg was done for 64 allograft biopsies showing HBV infection. RESULTS: Moderate to severe bile duct damage, diffuse centrilobular necrosis and centrilobular inflammation (p<0.000, for each) were more frequently observed in cases of ACR, whereas diffuse acidophilic bodies and spotty necrosis (p<0.000, for each) were more prevalent in cases of HBV infection. Immunopositivity for HBcAg (n=60, 93.8%) was higher than that for HBsAg (n=14, 21.9%) CONCLUSIONS: The presence of moderate to severe bile duct damage, diffuse centrilobular necrosis and centrilobular inflammation was a characteristic feature of ACR, whereas diffuse distribution of acidophilic bodies or spotty necrosis was the only characteristic feature of HBV infection. HBcAg was a more sensitive immunohistochemical marker than HBsAg for detecting HBV infection in liver allograft biopsies.

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Analysis of S Gene Mutation of the Hepatitis B Virus in Adult Liver Transplant Recipients Showing Resistance to Hepatitis B Immunoglobulin Therapy
G.-C. Park, S. Hwang, C.-S. Ahn, K.-H. Kim, D.-B. Moon, T.-Y. Ha, G.-W. Song, D.-H. Jung, Y.W. Shin, S.-H. Kim, K.-H. Chang, J.-M. Namgoong, C.-S. Park, H.-W. Park, Y.-H. Park, S.-H. Kang, B.-H. Jung, S.-G. Lee
Transplantation Proceedings.2013; 45(8): 3047. CrossRef
Posttransplantation prophylaxis with primary high-dose hepatitis B immunoglobulin monotherapy and complementary preemptive antiviral add-on
Shin Hwang, Chul-Soo Ahn, Gi-Won Song, Ki-Hun Kim, Deok-Bog Moon, Heung-Bum Oh, Young-Suk Lim, Han Chu Lee, Tae-Yong Ha, Dong-Hwan Jung, Young-Hwa Chung, Sung-Gyu Lee
Liver Transplantation.2011; 17(4): 456. CrossRef
Posttransplantation Prophylaxis with Primary High-dose Hepatitis B Immunoglobulin Monotherapy and Complementary Preemptive Antiviral Add-on. Liver Transpl 2011;17:456-465
Dong-Hwan Jung, Shin Hwang
The Korean Journal of Gastroenterology.2011; 57(5): 330. CrossRef

The Clinicopathological Parameters for Making the Differential Diagnosis of Neonatal Cholestasis.: Heejin Lee, Jun Kang, Kyung Mo Kim, Joo Young Jang, Se Jin Jang, Eunsil Yu; Korean J Pathol. 2009;43(1):43-47.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.1.43

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Abstract PDF

BACKGROUND
The diseases that cause neonatal cholestasis display several overlapping clinical feature. Making the differential diagnosis using liver biopsy specimens from infants with neonatal cholestasis is important for delivering the proper treatment.
METHODS
We assessed the clinical manifestations, laboratory data, and histopathologic features of the pretreatment liver biopsy specimens from patients suffering with biliary atresia (n=66), intrahepatic bile duct paucity (n=15), and neonatal hepatitis (n=21).
RESULTS
The gender distribution was nearly equal for the patients with biliary atresia and intrahepatic bile duct paucity, whereas males predominated for the cases of neonatal hepatitis. Only the gamma-glutamyl transferase level differed significantly amongst the groups. The diagnostic features for making the differential diagnosis of bile duct lesions included marked bile ductular proliferation, severe fibrosis, and bile duct loss. The difference of the average percentage of portal tracts with bile duct loss was statistically significant between the patients with intrahepatic bile duct paucity (73.9%) and those patients with neonatal hepatitis (39.1%) (p<0.001).
CONCLUSIONS
Bile ductular proliferation, bile duct loss, and advanced fibrosis are useful for the differential diagnosis of neonatal cholestasis. Moreover, stricter diagnostic criteria for bile duct loss (more than 2/3 of bile ducts) should be applied for the definitive diagnosis of intrahepatic bile duct paucity, because bile duct loss also frequently occurs in infants suffering with neonatal hepatitis.

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False-negative Hepatobiliary Scintigraphy for Biliary Atresia
Hyunji Kim, Sujin Park, Sejin Ha, Jae Seung Kim, Dae Yeon Kim, Minyoung Oh
Nuclear Medicine and Molecular Imaging.2019; 53(5): 356. CrossRef
Morphometric assessment of liver fibrosis may enhance early diagnosis of biliary atresia
Ahmed F. Abdalla, Abeer Fathy, Khaled R. Zalata, Ahmed Megahed, Ahmed Abo-Alyazeed, Mohammed Ezz El regal
World Journal of Pediatrics.2013; 9(4): 330. CrossRef
Differential hepatic expression of CD56 can discriminate biliary atresia from other neonatal cholestatic disorders
Mostafa Mohamed Sira, Mohamed Abdel-Salam El-Guindi, Magdy Anwar Saber, Nermin Ahmad Ehsan, Marwa Sabry Rizk
European Journal of Gastroenterology & Hepatology.2012; 24(10): 1227. CrossRef
Biliary Atresia: A Multidisciplinary Approach to Diagnosis and Management
Roger Klein Moreira, Rodrigo Cabral, Robert A. Cowles, Steven J. Lobritto
Archives of Pathology & Laboratory Medicine.2012; 136(7): 746. CrossRef
Tentative Proposal of Optimal Timing of Kasai Operation for Biliary Atresia Based on Fibroscan Results
Hwa Young Lee, Young A Park, Seok Joo Han, Hong Koh
Korean Journal of Pediatric Gastroenterology and Nutrition.2011; 14(1): 74. CrossRef

Clinicopathologic Analysis of Lymphocytic Gastritis.: Jeong Eun Hwang, Young Ok Hong, Dong Eun Song, Se Jin Jang, Eunsil Yu; Korean J Pathol. 2007;41(5):289-295.

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Abstract PDF: BACKGROUND
Lymphocytic gastritis (LG) is defined as an infiltration of more than 25 intraepithelial lymphocytes (IELs) per 100 surface epithelial cells, and the histological differential diagnosis of LG and residual mucosa associated lymphoid tissue (MALT) lymphoma can be difficult. Helicobacter pylori (H. pylori) is regarded as one of the possible causes of LG, but its clinicopathologic features of LG have not been clarified in Korea, which has a much higher prevalence of H. pylori infection than Western countries. We analyzed the clinicopathologic findings of LG in Korean patients and compared the cytologic findings of IELs of LG with those of MALT lymphoma.
METHODS
Sixty six cases of LG and 59 cases of MALT lymphoma were selected and clinicopathologic features were analyzed.
RESULTS
Eighteen cases (27.3%) of LG were found to be associated with H. pylori infection. The IELs in LG were found to diffusely and regularly infiltrate in the epithelium, but MALT lymphoma showed patchy IELs. IELs in LG and MALT lymphoma were CD 8+T lymphocytes and CD20+B lymphocytes, respectively. The mean nuclear size of IELs in LG was 4.37 micrometer, which was significantly smaller than those in MALT lymphoma (5.19 micrometer).
CONCLUSION
LG, a rare variant of chronic gastritis is partly associated with H. pylori infection and more complex unknown causative factors. In addition to the immunophenotyping, the nuclear sizes of IELs can be helpful in the differential diagnosis of LG and residual MALT lymphoma.

Immunohistochemical Profile of Acute Cellular Rejection in Renal Allograft.: Jongha Park, Seung Woon Byun, Eunsil Yu, Su Kil Park, Duck Jong Han, Yong Mee Cho; Korean J Pathol. 2007;41(1):15-20.

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Abstract PDF: BACKGROUND
We wanted to find an adjunctive marker(s) in renal allograft biopsies for predicting acute cellular rejection (ACR), and so the expression patterns of immune-related molecules were compared between ACR, borderline ACR and non-ACR cases.
METHODS
The expression patterns of Fas ligand (FasL), HLA-DR, granzyme B, caspase-3, CD56, interferon stimulated growth factor-3 (ISGF-3), and CD53 were assessed via immunohistochemical study in 75 allograft biopsies from patients with ACR (n=19), borderline ACR (n=22), and non-ACR (n=34).
RESULTS
Compared to those of the non-ACR group, the ACR group revealed an elevated number of FasL positive interstitial inflammatory cells, HLA-DR positive tubular inflammatory cells, cytoplasmic caspase-3 positive tubular epithelial cells, granzyme B positive interstitial mononuclear inflammatory cells and CD53 positive interstitial inflammatory cells. The expression patterns of the borderline ACR group were similar to those of non-ACR group, except for the intensity of FasL in the tubular epithelial cells.
CONCLUSIONS
Immunohistochemical investigations of the adjunctive markers FasL, HLA-DR, granzyme B, caspase-3 and CD56 can be useful for making the diagnosis of ACR.

Intraneural Perineurioma in the Tongue: A Case Report.: Jun Kang, Shin Kwang Khang, Jene Choi, Jeong Won Kim, Eul Ju Seo, Bu kyu Lee, Eunsil Yu; Korean J Pathol. 2007;41(1):51-54.

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Abstract PDF: We report a case of an intraneural perineurioma that developed in an unusual location, the tongue. A 16-year-old male presented with a 1 cm sized protruding submucosal mass in his tongue without any sensory or motor signs or symptoms. The mass was excised. The mucosa was intact, with an ill-defined firm mass measuring 1.0 x 0.8 x 0.6 cm in the submucosa and muscle. The cut surface of the mass was pinkish gray and fibrotic. Microscopically, the mass contained tortuous and thickened peripheral nerve bundles in the submucosa, showing onion bulb like structures. The onion bulb like structures consisted of centrally located S-100 protein positive Schwann cells surrounded by Glut-1 positive perineurial cells. The FISH study did not reveal any genetic aberrations in chromosome 22.

Clinicopathological Analysis of Eight Cases of Idiopathic Portal Hypertension.: Kyungeun Kim, Young Suk Lim, Kyung Mo Kim, Eunsil Yu; Korean J Pathol. 2006;40(5):348-353.

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Abstract PDF: BACKGROUND
Idiopathic portal hypertension (IPH) is a rare clinicopathologic entity that shows clinical evidences of portal hypertension with no pathologic features of cirrhosis.
METHODS
The clinical and pathologic features of 8 cases with IPH were analyzed via the medical records along with the biopsy or resected liver specimens.
RESULTS
Six patients were male and two were female. The chief complaints were sudden variceal bleeding in seven patients and abdominal pain in one patient. Six patients were treated with varix ligation and one was treated with splenectomy after the failure of bleeding control. One patient underwent a liver transplantation due to severe symptoms of portal hypertension. The prognosis of all the patients was excellent. Microscopically, the portal tracts were variably fibrotic, and the portal veins in them were sclerotic, obliterated or dilated in 7 cases; pathologic abnormalities were absent in 1 case. Cirrhosis was absent in all cases, while septal fibrosis was present in one resected liver.
CONCLUSIONS
IPH is a minor cause of portal hypertension. However, a liver biopsy to show the subtle portal vascular changes and fibrosis in patients who have the clinical symptoms of portal hypertension is important for making the diagnosis of IPH.

Expression of the 14-3-3 sigma Protein and Methylation Status of the 14-3-3 sigma gene in Biliary Neoplasms.: Dong Eun Song, Se Jin Jang, Jung Sun Kim, Sang Soo Lee, Myung Hwan Kim, Seung Gyu Lee, Young Joo Lee, Hae Joung Park, Yhong Hee Shim, Eunsil Yu; Korean J Pathol. 2006;40(1):9-16.

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Abstract PDF: BACKGROUND
The 14-3-3 sigma (sigma) protein has a negative regulatory role in the cell cycle progression of the. Down-regulation or overexpression of the 14-3-3 sigma protein has been reported in various human cancers.
METHODS
Immunohistochemistry for the 14-3-3 sigma protein was performed in non-neoplastic bile duct cells, intraductal papillary neoplasms of the liver (IPNL), mass-forming intrahepatic cholangiocarcinomas (ICC) and non-papillary extrahepatic cholangiocarcinomas (ECC). We investigated the methylation status of the 14-3-3 sigma gene in 45 cases of these 3 tumor groups.
RESULTS
The non-neoplastic bile duct cells demonstrated negative or weakly positive cytoplasmic immunoreactivity for the 14-3-3 sigma protein and no methylation of the 14-3-3 sigma gene. Overexpression as well as negative immunoreactivity associated with hypermethylation of the 14-3-3 sigma protein was observed in 16 (69.6%) of 23 cases of IPNL, in 21 (63.6%) of 33 cases of mass-forming ICC and in 27 (71.1%) of 38 cases of non-papillary ECC. Negative immunoreactivity was increased in the invasive IPNL (4/6, 66.7%), as well as in the poorly differentiated cases of mass-forming ICC (8/12, 66.7%) and the non-papillary ECC (5/8, 62.5%).
CONCLUSIONS
The similar rates for the abnormal expression of the 14-3-3 sigma protein among the three groups of biliary neoplasms indicate its general association with biliary carcinogenesis. Furthermore, the loss of the 14-3-3 sigma protein may be involved in the tumor progression and differentiation in the biliary carcinogenesis.

A Case of Combined Hepatocellular and Cholangiocarcinoma with Neuroendocrine Differentiation and Sarcomatoid Transformation: A Case Report.: Mi Jung Kim, Hyun Lyoung Koo, Seung Kyu Lee, Jae Y Ro, Eunsil Yu; Korean J Pathol. 2005;39(2):125-129.

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Abstract PDF: We report here on a case of combined hepatocellular and cholangiocarcinoma (CHC) with neuroendocrine differentiation and sarcomatoid transformation. A 59-year-old male who had had HBV-associated chronic liver disease presented with hepatic masses. The explanted liver showed three small masses, two in the right lobe and one in the left lobe. The largest one in the right lobe was a 2.0 cm sized binodular mass,consisting of a yellowish tan nodule and an abutting reddish brown nodule. Microscopically, the reddish brown nodule was a cholangiocarcinoma (CC) showing neuroendocrine differentiation and sarcomatoid tranformation. The yellowish tan nodule and the remaining two masses were hepatocellular carcinoma (HCC)s. On immunohistochemistry, both the adenocarcinoma and spindle sarcomatoid cells were positive for pancytokeratin, but only the adenocarcinoma cells were positive for chromogranin and carcinoembryonic antigen (CEA). Mitotic and Ki67 labeling indices as well as p53 immunopositivity were significantly increased only in the CC component. We report here on the first case of CHC in which the CC displayed neuroendocrine differentiation and sarcomatoid transformation with high mitotic and Ki67-labeling indices, as well as having p53 overexpression.

Differential Expression of Promyelocytic Leukemia Protein in Autoimmune Liver Diseases.: Hyun Jung Kim, Jung Sun Kim, Yong Sang Lee, Young Hwa Chung, Han Joo Lee, Dong Jin Suh, Chong Jai Kim, Eunsil Yu; Korean J Pathol. 2004;38(6):357-363.

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Abstract PDF: BACKGROUND
Promyelocytic leukemia protein (PML) is a primary biliary cirrhosis (PBC)-specific autoantigen. Anti-PML antibody is analyzed using cultured cells with patient sera, however, PML expression has rarely been examined in liver tissues.
METHODS
In the present study, PML expression was examined immunohistochemically in paraffin embedded liver needle biopsy specimens obtained from 20 cases of PBC, 10 cases of autoimmune cholangitis, 36 cases of autoimmune hepatitis and from 5 cases of noninflammatory livers.
RESULTS
Variable PML immunopositivity was detected in the bile duct epithelial cells of 18 (90.0%) of 20 PBC cases and in all 10 cases (100.0%) of autoimmune cholangitis, whereas it was only present in 6 (16.7%) of 36 cases of autoimmune hepatitis (p<0.001). In contrast, hepatocyte PML immunopositivity was higher in autoimmune hepatitis (33/36 cases, 90.8%), than in PBC (10/20 cases, 50.0%) or autoimmune cholangitis (3/10 cases, 30.0%) (p<0.05).
CONCLUSION
Our data indicate that the differential expression of PML is closely related to autoimmune liver diseases type, and suggest that the overexpression of PML protein in bile duct cells is associated with the development of autoantibodies in patients with PBC or autoimmune cholangitis. Furthermore, PML immunoreactivity may be useful for the diagnosis of autoimmune cholangitis and overlap syndrome.

Renal Malakoplakia with Secondary Hepatic Extension: A Case Report.: Dong Eun Sung, Eunsil Yu, Chung Su Kim, Jae Y Ro; Korean J Pathol. 2003;37(3):199-203.

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Abstract PDF: Renal malakoplakia (RM) with secondary hepatic involvement is extremely rare. There are only two cases reported in literature. We report the first case of RM with secondary hepatic extension in Korea. A 70-year-old woman had a history of long-term oral steroids intake. A radical nephrectomy and a segmental hepatectomy were performed under the clinical impression of a renal cell carcinoma with hepatic extension on the dynamic liver computed tomography. The gross specimen revealed a lobulated yellowish-tan, soft mass (9 X 8 X 5 cm) with hepatic involvement in the upper pole of the right kidney. The hematoxylin and eosin, Prucian blue and von-Kossa stainings, and electron microscopy demonstrated the classical histologic features of malakoplakia with Von Hansemann histiocytes containing Michaelis-Gutmann bodies. The patient is well 5 months after surgery. This case emphasizes that initial diagnoses can be difficult because of the rare occurrence of RM and its resemblance to renal cell carcinoma with hepatic extension.

Primary Mucinous Cystic Neoplasm of the Retroperitoneum: A Report of Three Cases.: Dong Eun Song, Mi Jung Kim, Shin Kwang Shin, Eunsil Yu, Kyung Ja Cho; Korean J Pathol. 2003;37(3):204-209.

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Abstract PDF: Primary mucinous cystic neoplasms of the retroperitoneum in women are rare and show histologic features similar to their ovarian or pancreatic counterparts. We present three cases of primary retroperitoneal mucinous neoplasms of variable malignant potentials including a cystadenocarcinoma in a 50-year-old woman, a cystic neoplasm of borderline malignancy in a 31-year-old woman, and a cystadenoma in a 67-year-old woman. All cases showed histologic features similar to mucinous tumors of the ovary. Immunohistochemical study demonstrated positivity for calretinin in case 3. The histogenesis of these neoplasms can be assumed most likely to be mucinous metaplasia of the mesothelium or undetected heterotopic pancreatic tissue. Appropriate management is thought to be the same as for analogous ovarian neoplasms.

Recurrent Viral Hepatitis Following Liver Transplantation: Report of 4 Cases.: Sunhee Chang, Kwangseon Min, Jaegul Jung, Ghil Suk Yoon, Seung Kyu Lee, Yung Sang Lee, Eunsil Yu; Korean J Pathol. 2002;36(2):122-127.

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Abstract PDF: The recurrence of viral hepatitis B or C after liver transplantation is almost universal but their clinical courses and outcomes are vary widely. We investigated four cases of rapidly progressive and fatal recurrent viral hepatitis following liver transplantation, which were rapidly progressive and fatal. Case 1 was a 58-year-old male, who developed recurrent viral hepatitisC. Case 2, 3, and 4 were a 59-year-old female, a 42-year-old male, and a 50-year-old male, respectively, who developed recurrent viral hepatitis B. In cases 1 and 2, the histopathological features of the first liver biopsies were prominent ballooning degeneration of the hepatocytes but later biopsies revealed significant lobular activity. Case 3 began with a marked fatty change and mild lobular and porto-periportal activity and progressed to severe lobular activity and septal fibrosis. In case 4, the first liver biopsy revealed minimal lobular activity but the second biopsy revealed severe lobular activity.

Posttransplant Lymphoproliferative Disorder: A Report of 4 Cases.: Sunhee Chang, Jooryung Hugh, Kyung Mo Kim, Duck Jong Han, Seung Kyu Lee, Eunsil Yu; Korean J Pathol. 2002;36(1):45-50.

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Abstract PDF: Posttransplant lymphoproliferative disorder (PTLD) is a proliferation of B-cells associated with Epstein-Barr virus (EBV) infection as a complication of immunosuppression, especially by FK506. We investigated four cases of PTLD which developed either in allografts or in other organs.
Case
1 was a 38-year-old woman, who developed monomorphic PTLD in a kidney 7 years and 7 months after renal transplantation. Case 2 was a 37-year-old man, who developed monomorphic PTLD in the right submandibular lymph node 4 months after liver transplantation. Case 3 was a 60-year-old man, who developed monomorphic PTLD in the liver 8 months after liver transplantation. Case 4 was a 2-year-old female child, who developed polymorphic PTLD in the colon, liver, and mesenteric lymph node 10 months after liver transplantation. FK506 was administered to case 4. EBV was identified in the tissues of all cases by immunohistochemistry and/or in situ hybridization.

S100 Protein Positive Dendritic Cells in Liver Diseases.: Ghil Suk Yoon, Inchul Lee, Eunsil Yu; Korean J Pathol. 1998;32(8):590-595.

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Abstract: We describe S100 protein positive dendritic cells (S100+DCs) in various liver diseases including chronic viral hepatitis B and C (20 cases), liver cirrhosis (3 cases), hepatocellular carcinoma (2 cases), hepatolithiasis (6 cases), primary biliary cirrhosis (PBC) (2 cases), liver allograft rejection (9 cases), bile duct paucity (1 case), and Wilson's disease (1 case). By immunohistochemical analysis, S100+DCs were absent in fetal and normal livers, while they were variably present in inflammatory liver diseases. In chronic hepatitis and active cirrhosis, S100+DCs were most frequently located in periportal area, at lymphoid follicles within the portal tract, and at foci of spotty necrosis within the lobule. Frequency and intensity of S100+DCs were not related to etiologies of liver diseases, but they were correlated with the activity of hepatitis. In PBC, S100+DCs were found between biliary epithelial cells of the septal bile ducts, as well as, the periductal area of the portal tracts. A posttransplantation liver with features of moderate acute rejection revealed many S100+DCs in polymorphous portal infiltrates. In hepatocellular carcinomas, many S100+DCs were scattered between tumor cells. In the case of the Wilson's disease, S100+DCs were not noted. Presence of S100+DCs in various inflammatory liver diseases indicates that they play a central role as antigen presenting cells in immune responses of inflammatory liver diseases.

Pathological Analysis of Post-Transplantation Endomyocardial Biopsies.: Jaegul Chung, Soonae Oak, Gheeyoung Choe, Gyungyub Gong, Jooryung Huh, Eunsil Yu, Inchul Lee, Meong Gun Song, Kwang Hyun Sohn, Jae Joong Kim, Jong Goo Lee; Korean J Pathol. 1995;29(4):431-441.

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Abstract PDF: Heart transplantation was first performed in 1967. It is now regarded as a well-established treatment modality for end-stage cardiac diseases. Once the transplantation is performed, endomyocardial biopsy(EMB) is the examination of choice in monitoring the transplanted heart. We analyzed the pathological findings of follow-up EMB of 6 heart transplant patients. All patients have been suffered from severe heart failure. Four patients were adult male and two were adult females. All the hearts, except for one, displayed characteristic features of dilated cardiomyopathy. The remaining heart was diagnosed as having giant cell myocarditis. Post-transplantion EMBs were performed according to the protocol and standard cardiac biopsy grading of ISHT (1990). The standards were applied for grading of cellular rejection. In five patients, there were one or two episodes of biopsy proven acute rejection, grade II or IIIA without any clinical symptoms of rejection. Immediate "pulse therapy" was performed and follow-up biopsies were done. All episodes of rejection were cleared in subsequent biopsies. All patients are doing well without evidence of cardiac problem. The postoperative monitoring of acute rejection is critical since clinical signs of rejection are usually absent. At present, EMB is regarded as the most reliable method for diagnosis and grading of acute rejection and is an efficient guide to the monitoring of the cardiac recipients. Our experience of post-transplantation EMB corresponds with previously published reports.

Cytologic Features of Primary Tumors in Central Nervous System.: Soonae Oak, Jaegul Chung, Gyungyub Gong, Gheeyoung Choe, Eunsil Yu, Inchul Lee; Korean J Cytopathol. 1994;5(2):90-98.

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Abstract PDF: There has been a marked increase in the utility of aspiration cytology for pathologic diagnosis. It may be applied to any kinds of organs and substitutes surgical biopsy. Because of the high risk of complication and difficulties in localization, aspiration cytology in the central nervous system(CNS) has been used with less frequency compared to other sites. However, with the advent of sophisticated imaging instruments, aspiration cytology of lesions in the CNS is being used increasingly. Cytologic features of the CNS neoplasms were quite similar to those of histology except one spindle cell tumor. Reviewing various CNS neoplasms, it appears that cytology may be a useful diagnostic method.

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