- Chronic Sclerosing Dacryoadenitis: Report of 2 Cases.
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Ji Eun Kwon, Sang Kyum Kim, Sang Ryul Lee, Woo Ick Yang, Haeryoung Kim
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Korean J Pathol. 2008;42(2):118-122.
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- Chronic sclerosing dacryoadenitis is a rare and under-recognized chronic inflammatory disease of the lacrimal gland. We describe 2 patients with a localized type of chronic sclerosing dacryoadenitis. Both patients presented with a slowly growing painless mass of the eyelid mimicking a tumorous lesion. The morphologic findings of the masses excised under the clinical diagnosis of lymphoma closely recapitulate those of chronic sclerosing sialadenitis (Kuttner tumor). Immunohistochemical staining demonstrated an increased population of IgG4-positive plasma cells confirming that this disease also belongs to the spectrum of a recently described IgG4-related sclerosing disease.
- Salivary Duct Carcinoma with Mucin Containing Cells: Report of a Case Misdiagnosed as Mucoepidermoid Carcinoma on Fine Needle Aspiration Cytology.
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Haeryoung Kim, Hyunki Kim, Hoguen Kim, Jin Kim, Soon Won Hong, Se Hoon Kim
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Korean J Cytopathol. 2006;17(1):56-62.
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- Salivary duct carcinoma (SDC) is a rare primary salivary gland malignancy characterized by histological features similar to those of ductal carcinomas of the breast. It is regarded as a high-grade malignancy associated with frequent local recurrences and early distant metastases that require aggressive treatment. The typical fine needle aspiration cytology (FNAC) findings in SDC include cellular smears showing tumor cells with eccentric pleomorphic nuclei and a granular cytoplasm arranged in flat sheets or cribriform patterns against a necrotic background. However, the presence of mucin-containing cells in SDC has been rarely described. We report the FNAC findings in a patient with histologically confirmed SDC that demonstrated numerous mucin-containing cells and was subsequently misdiagnosed as a high-grade mucoepidermoid carcinoma. Here we discuss the problems involved in distinguishing SDC from high-grade mucoepidermoid carcinoma on the basis of cytologic findings alone.
- Pleomorphic Variant of Pineocytoma: A Case Report.
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Eunah Shin, Haeryoung Kim, Tae Seung Kim, Se Hoon Kim
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Korean J Pathol. 2004;38(4):265-267.
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- We herein present a rare case of pineocytoma in a 23-year-old female exhibiting distinct histomorphological features. The tumor contained highly pleomorphic, often multinucleated giant cells in the background of otherwise benign pineocytomatous architecture, which at first led to an erroneous diagnosis of a high grade malignancy. However, the worrisome histological findings turned out to be constituents of a distinct subtype of pineocytoma previously described as pleomorphic variant of pineocytoma. Although it is rare, pathologists should be aware of this entity since the tumor takes on a benign clinical course like any other classic pineocytomas.
- Pseudofungi Associated with a Granulomatous Response in a Lymph Node: A Case Report.
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Haeryoung Kim, Ja Seung Koo, Hyosup Shim, Gijong Yi, Sang Ho Cho
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Korean J Pathol. 2004;38(1):64-67.
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We present herein a case of pseudofungi incidentally found in the mediastinal lymph nodes of a 31-year-old woman who had a left pneumonectomy for a pulmonary blastoma. The pseudofungi were located in the subcapsular sinuses of the lymph nodes with an associated granulomatous reaction. They revealed yellowish-brown hyphae-like structures with pseudosepta and irregular branching at various angles intermingled with round yeast-like forms. These structures stained positively with periodic acid-Schiff and Gomori methenamine silver, but also stained strongly positive for Prussian blue suggesting that they contain iron. The characteristic morphological features of pseudofungi are discussed with emphasis on the features that distinguish them from true fungal organisms.
- Macrofollicular Variant of Papillary Thyroid Carcinoma with Extensive Hemorrhage.
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Haeryoung Kim, SoonWon Hong, Kwang Gil Lee, Eun Kyung Kim, Cheong Soo Park, Woung Youn Chung, Woo Ick Yang
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Korean J Cytopathol. 2004;15(1):60-64.
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- BACKGROUND
The macrofollicular variant of papillary thyroid carcinoma (MVPC) is characterized by macrofollicles occupying more than half of the tumor and demonstrating nuclear features of classic papillary carcinoma. It is difficult to recognize on fine needle aspiration (FNA) cytology due to the paucity of aspirated neoplastic cell clusters, especially when the tumor is associated with extensive areas of hemorrhage.
CASE
A 34-year-old female presented with a well-demarcated nodule in the thyroid gland, diagnosed as a benign nodule on ultrasonography and computed tomography. FNA cytology smear revealed a few small aggregates of follicular cells with morphological features suspicious for papillary carcinoma, set in a background of hemorrhage, inflammatory cells, and hemosiderin-laden macrophages. Intraoperative frozen section revealed macrofollicular nests filled with hemorrhage and composed of follicular cells demonstrating nuclear clearing and grooves.
CONCLUSION
MVPC is a rare but distinctive variant of papillary carcinoma, which is easily mistaken for adenomatous goiter or benign macrofollicular neoplasm on radiologic findings. The cytopathologist should alert oneself on encountering benign radiologic findings and any smear composed of scant numbers of follicular cells with nuclear features suspicious for papillary carcinoma despite the bland-looking background of hemorrhage and hemosiderin-laden macrophages, and recommend intraoperative frozen sections for a definite diagnosis.
- Fine Needle Aspiration Cytology of Kimura's Disease of Parotid Gland: Report of A Case Cytologically Failed to Diagnose as Kimura's Disease.
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Se Hoon Kim, Haeryoung Kim, Sung Eun Kim, Woo Ick Yang, Soon Won Hong, Kwang Gil Lee
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Korean J Cytopathol. 2003;14(2):86-90.
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- Kimura's disease is a chronic inflammatory disorder of unknown cause and is most prevalent among Asians. The cytologic findings of Kimura's disease are significant numbers of eosinophils in a background of lymphoid cells, occasional fragments of collagenous tissue, proliferation of vessels, and Warthin-Finkeldey polykaryocytes. Among these features, the most important cytologic feature of Kimura's disease is a significant numbers of eosinophils. We experienced a case of Kimura's disease in the parotid gland which we failed to recognize on cytology due to the apparent paucity of eosinophils. On careful retrograde reviewing of the cytologic findings, a few scattered leukocytes, previously interpreted as polymorphous leukocytes, had bilobed nuclei and coarse green but granular cytoplasm on Papanicolaou preparation. These leukocytes showed obvious orange-red intracytoplasmic granules as in eosionophils on Giemsa stain. The paucity of eosinophils may be due to the thick fibrosis around lymphoid follicles or any technical error during aspiration. Whereas the Warthin-Finkeldey type giant cell is not a sensitive cytologic marker of Kimura's disease, it may be a helpful cytologic feature. To reach a correct cytologic diagnosis of Kimura's disease, it is important to keep in mind that searching for Warthin-Finkeldey type giant cells and evaluation of Giemsa stain for detection of eosinophils would be helpful.
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