Journal of Pathology and Translational Medicine

Jinyoung Yoo

40 Articles

Pathologic Differences between Placentas from Intrauterine Growth Restriction Pregnancies with and without Absent or Reversed End Diastolic Velocity of Umbilical Arteries.: Changyoung Yoo, Dong Gyu Jang, Yun Sung Jo, Jinyoung Yoo, Guisera Lee; Korean J Pathol. 2011;45(1):36-44.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.1.36

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BACKGROUND
Abnormal umbilical artery Doppler velocimetry is one of the important findings of intrauterine growth restriction (IUGR) and IUGR is associated with high perinatal morbidity and mortality. In addition, this abnormal Doppler velocimetry is correlated with placental insufficiency. The aim of this study was to determine the pathologic differences in the placentas from IUGR pregnancies with and without the absent or reversed end diastolic velocity (AREDV).
METHODS
Among the cases that had undergone prenatal follow-up in our institute, a retrospective slide review was conducted for 18 cases of IUGR with AREDV and 17 cases with IUGR that had normal end-diastolic flow of the umbilical artery.
RESULTS
The birth weight and the other clinical parameters were not different among the two groups. Grossly, the placental weight percentiles were significantly smaller in AREDV group when they were adjusted according to gestational age. Histologically, chronic deciduitis, mural hypertrophy of the decidual arteries, an intimal fibrin cushion of the large fetal vessels, increased syncytial knots, villous agglutinations, avascular villi, villous stromal-vascular karyorrhexis, and acute atherosis were more frequently found in the AREDV group and their presence showed statistical significance.
CONCLUSIONS
These findings suggest that pathologic abnormalities due to fetal and maternal vasculopathies in the placenta may be the cornerstone for inducing AREDV in the umbilical artery.

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Defining early vs late fetal growth restriction by placental pathology
Amir Aviram, Christopher Sherman, John Kingdom, Arthur Zaltz, Jon Barrett, Nir Melamed
Acta Obstetricia et Gynecologica Scandinavica.2019; 98(3): 365. CrossRef
HISTOPATHOLOGICAL CHANGES OF PLACENTA IN PRETERM PREGNANCY WITH SPECIAL REFERENCE TO INTRAUTERINE GROWTH RESTRICTION
Prathibha S.D, Anitha N, Samikshya Ray, Jayaprakash H.T
Journal of Evidence Based Medicine and Healthcare.2016; 3(63): 3430. CrossRef
Preliminary Study on Neurodevelopmental Outcome and Placental Pathology among Extremely Low Birth Weight Infants
Seong-Hee Oh, Jong-jae Kim, Hyun-jeong Do, Byong Sop Lee, Ki-Soo Kim, Ellen Ai-Rhan Kim
Korean Journal of Perinatology.2015; 26(1): 67. CrossRef
Chronic Placental Inflammation in Twin Pregnancies
Heejin Bang, Go Eun Bae, Ha Young Park, Yeon Mee Kim, Suk-Joo Choi, Soo-young Oh, Cheong-Rae Roh, Jung-Sun Kim
Journal of Pathology and Translational Medicine.2015; 49(6): 489. CrossRef

Malignant Fibrous Histiocytoma Arising in a Mature Cystic Teratoma of the Ovary: A Case Report.: Soyoung Im, Sun Mi Lee, Ji Han Jung, Hyun Joo Choi, Jinyoung Yoo, Seok Jin Kang, Kyo Young Lee; Korean J Pathol. 2010;44(3):322-325.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.3.322

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Abstract PDF: A 50-year-old female patient presented with anorexia and weight loss. Pelvic computed tomography revealed a 12.5 x 7.3 cm heterogeneous mass in the left ovary. About 30% of the tumor was occupied by a mature cystic teratoma. The remaining solid portion was composed of fibrous and histiocytic elements, arranged in storiform patterns admixed with bizarre giant cells. The mitotic index was 8 per 10 high power fields, including atypical mitoses. The only immunopositivity was for vimentin. The tumor was diagnosed as a malignant fibrous histiocytoma arising in a mature cystic teratoma. To the best of our knowledge, this is only the third such case in the English language literature.

Complex Bronchopulmonary Foregut Malformation: Extralobar Pulmonary Sequestration Communicating with an Esophageal Duplication Cyst: A Case Report.: Soyoung Im, Sun Mi Lee, Ji Han Jung, Jinyoung Yoo, Kyu Do Cho, Seok Jin Kang, Kyo Young Lee; Korean J Pathol. 2010;44(2):207-210.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.2.207

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Abstract PDF

We report here on a case of a rare, complex bronchopulmonary foregut malformation (BPFM) that was composed of an extralobar pulmonary sequestration communicating with an esophageal duplication cyst. A 33-year-old female presented with an incidentally detected chest mass. The computed tomography revealed a 7.5 x 4.0 cm sized heterogeneous, solid and cystic lesion in the right superior mediastinum. Surgical resection demonstrated the solid portion to be isolated lung tissue invested in its own pleura. A unilocular cyst was communicating with the bronchus of the sequestrated lung, and microscopically the cyst was lined by squamous epithelium overlying the thick layers of smooth muscle. This case is important for understanding the spectrum of BPFMs and for differentiating a mediastinal mass, especially one at the unusual location.

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Prenatal ultrasound, magnetic resonance imaging and therapeutic options for fetal thoracic anomalies: a pictorial essay
Pablo Caro-Domínguez, Teresa Victoria, Pierluigi Ciet, Estrella de la Torre, Ángel Chimenea Toscano, Lutgardo García Diaz, José Antonio Sainz-Bueno
Pediatric Radiology.2023; 53(10): 2106. CrossRef
Concurrent bronchopulmonary foregut malformations: a rare case of right-sided extralobar pulmonary sequestration and bronchogenic cyst
Carolyn Hanna, Priya G. Sharma, Moiz M. Mustafa, Jennifer Reppucci, Archana Shenoy, Dhanashree Rajderkar
Egyptian Journal of Radiology and Nuclear Medicine.2021;[Epub] CrossRef

Alteration of G1/S Cell Cycle Regulatory Proteins in Carcinogenesis of Cutaneous Squamous Cell Carcinomas.: Soyoung Im, Changyoung Yoo, Ji Han Jung, Hyun Joo Choi, Jinyoung Yoo, Seok Jin Kang, Kyo Young Lee; Korean J Pathol. 2009;43(6):542-549.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.6.542

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Abstract PDF

BACKGROUND
Aberration of the cell cycle regulatory proteins has been reported to contribute to the development and progression of human malignancy. We studied the expression of G1/S cell cycle regulatory proteins to investigate the carcinogenesis in cutaneous squamous cell lesions. METHODS: We evaluated the expressions of p16, pRb, cyclin D1 and Ki-67 protein by immunonohistochemistry in cases of normal skin (n=15), seborrheic keratosis (SK; n=26), actinic keratosis (AK; n=30), Bowen's disease (BD; n=37), keratoacanthoma (KA; n=23), and squamous cell carcinoma (SCC; n=22). RESULTS: The Ki-67 expression gradually increased from SK, through AK, to BD. The expression of p16 was more increased in BD than that in AK. The decreased expressions of p16 and Rb, and the increased expression of cyclin D1 were observed to a greater degree in SCC than those in BD. The expressions of cyclin D1 and Ki-67 were higher in SCC than those in KA. CONCLUSIONS: The altered expressions of p16, Rb, and cyclin D1 were considered to be related to the carcinogenesis in the cutaneous squamous cell lesions. Therefore, immunohistochemical studies of the cell cycle regulatory proteins and a combined analysis may be helpful as an adjunct to the histomorphology in the diagnosis of cutaneous squamous cell lesions.

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Expression of pRb, p53, p16 and Cyclin D1 and Their Clinical Implications in Urothelial Carcinoma
Kyungji Lee, Eun Sun Jung, Young-Jin Choi, Kyo Young Lee, Ahwon Lee
Journal of Korean Medical Science.2010; 25(10): 1449. CrossRef

Predictive Significance of KRAS and Tau for Chemoresponse in Advanced Non-Small-Cell Lung Cancer.: Jinyoung Yoo, Byoung Yong Shim, Chang Young Yoo, Seok Jin Kang, Kyo Young Lee; Korean J Pathol. 2009;43(5):435-440.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.5.435

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Abstract PDF

BACKGROUND
Taxane-platinum combinations are often used as first-line treatments for patients with advanced non-small cell lung cancer (NSCLC). Response to chemotherapy for these patients is still poor. The aim of our study was to investigate, for this disease, whether KRAS and Tau proteins affect responses to taxane-platinum combinations.
METHODS
Expression of KRAS and Tau was examined immunohistochemically in 71 tumor samples obtained from patients with stage IIIB or IV NSCLC prior to combination therapy. Expression was correlated with tumor responses.
RESULTS
The response rate was 55% (39 of 71). KRAS and Tau were expressed in seven (10%) and 31 (44%) patients, respectively. All seven KRAS-positive patients were non-responders (p=0.014). Among Tau-positive patients, 35% (11 of 31) responded to therapy, whereas a partial response was observed in 70% (28 of 40) of Tau-negatives (p=0.045). Two were positive for both, and they were non-responders. In patients negative for both, the response rate was 71% (25 of 35) (p=0.012).
CONCLUSIONS
Expression of KRAS and Tau are significantly correlated with poor responses to this combination therapy in advanced NSCLC patients, and may be a useful marker for chemoresistance.

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Emerging Evidences for an Implication of the Neurodegeneration-Associated Protein TAU in Cancer
Stéphanie Papin, Paolo Paganetti
Brain Sciences.2020; 10(11): 862. CrossRef

Schwannoma Arising in a Lymph Node : A Brief Case Report.: Ji Han Jung, Jinyoung Yoo, Seok Jin Kang, Kyo Young Lee; Korean J Pathol. 2009;43(3):271-273.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.3.271

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Abstract PDF

Intranodal schwannomas are extremely rare and only three cases have currently been reported in the English language literature. We report here on a case of a schwannoma that arose in a retroperitoneal lymph node. A 59-year-old male patient had experienced abdominal discomfort for two months. An abdominal CT scan demonstrated a heterogeneous density mass in the retroperitoneum. Histological examination of the mass identified it as a lymph node due to the presence of a peripheral rim of compressed lymphoid tissue that contained a well-demarcated benign spindle cell tumor in its center. The spindle cells were positive for S-100 protein, and they were negative for smooth muscle actin, desmin, and CD 34. Although an intranodal schwannoma is histologically benign, it is important to distinguish this lesion from an intranodal metastasis of a spindle cell tumor and other common benign spindle cell tumors that can arise in a lymph node.

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Submandibular nodal schwannoma: where did it come from?
Siti Farhana Abdul Razak, Hardip Singh Gendeh, Anuar Idris
BMJ Case Reports.2023; 16(8): e253868. CrossRef
Intranodal Neurofibroma: A Case Report and Literature Review
Steven H. Adams, Tara L. Huston, Daniel Lozeau
The American Journal of Dermatopathology.2022; 44(4): 306. CrossRef
Cervical Lymph Node Schwannoma—An Unexpected Diagnosis
Catarina Falcão Silvestre, Joana Almeida Tavares, Dolores López-Presa, Vanessa Rebelo dos Santos, José Rocha, Maria João Bugalho
Clinical Pathology.2019; 12: 2632010X1982923. CrossRef
Mesenteric intranodal schwannoma: uncommon case of neurogenic benign tumor
Adrian Medina-Gallardo, Yuhamy Curbelo-Peña, Jose Molinero-Polo, Maria Saladich-Cubero, Xavier De Castro-Gutierrez, Helena Vallverdú-Cartie
Journal of Surgical Case Reports.2017;[Epub] CrossRef
Intranodal Hybrid Benign Nerve Sheath Tumor
Brian D. Hayes, Maureen J. O'Sullivan
Pediatric and Developmental Pathology.2011; 14(4): 313. CrossRef
Intranodal Schwannoma Mimicking a Gastrointestinal Stromal Tumor of the Stomach: A Case Report
Kyung Bum Nam, Sook Namkung, Heung Cheol Kim, Hae Sung Kim, Byoung Yoon Ryu, Young Hee Choi
Journal of the Korean Society of Radiology.2011; 65(4): 395. CrossRef

An Analysis of HER-2/neu, ERCC1, and GST-pi in Advanced Non-Small Cell Lung Cancer Patients Who are Treated with Platinum-based Chemotherapy.: Kyung Jin Seo, Byoung Yong Shim, Hoon Kyo Kim, Ji Han Jung, Jinyoung Yoo, Seok Jin Kang, Kyo Young Lee; Korean J Pathol. 2008;42(6):327-334.

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Abstract PDF: BACKGROUND
Platinum-based chemotherapy has shown to be an effective first-line treatment for patients with advanced stage, unresectable non-small cell lung cancer (NSCLC). We evaluated the response rate to combination chemotherapy with cisplatin and taxane, and the significance of the HER-2/neu, ERCC1, and GST-pi status as predictive markers for the tumor response. METHODS: The HER-2/neu, ERCC1, and GST-pi status were analyzed in the biopsy specimens obtained from 35 patients with advanced stage NSCLC prior to cisplatin plus either paclitaxel or docetaxel chemotherapy. RESULTS: The response rate of the tumors to combination chemotherapy was 62.9% (22/35). HER-2/neu was amplified in 51.4% (18/35) of the tumors, and this was observed exclusively in patients with progressive disease (p=0.014). ERCC1 was overexpressed in 77.2% of the specimens (27/35), and this showed a tendency to correlate with the tumor response (p=0.057). GST-pi was detected in 85.7% of the specimens (30/35). Seventy-seven percent of the patients with a negative HER-2/neu and positive ERCC1 status showed a partial response, which was in contrast to only a 25% response rate for the patients with a positive HER-2/neu and negative ERCC1 status (p=0.006). The overall survival was prolonged in the patients without HER-2/neu amplification (15 vs 8.5 months, respectively, p=0.008). On multivariate analysis, the HER-2/neu status remained the significant predictor of survival (p=0.005). CONCLUSIONS: A combination of the ERCC1, HER-2/neu status may define a subset of patients with the most favorable response to combination chemotherapy regimens for treating advanced NSCLC.

Adenocarcinoma Arising in Type 1 Congenital Cystic Adenomatoid Malformation: A Case Report and Review of the Literature.: Jinyoung Yoo, Sun Mi Lee, Ji Han Jung, Myeong Im Ahn, Deog Gon Cho, Seok Jin Kang, Kyo Young Lee; Korean J Pathol. 2008;42(6):396-400.

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Abstract PDF: Malignancies in congenital cystic adenomatoid malformations (CCAMs) of the lung are rare. We report a 41-year-old male patient with a pulmonary cystic lesion suspicious for CCAM, unrecognized until the patient was 40 years of age, and which subsequently became more consolidated during the interval between initial presentation and surgery. Microscopic examination of the resected specimen revealed features of type 1 CCAM with a mucinous adenocarcinoma, metastatic to the mediastinal lymph nodes. This case illustrates the importance of prompt surgical resection for all suspected CCAMs, especially those discovered in adulthood.

Protein Expression and Gene Amplification of Epidermal Growth Factor Receptor in Non-Small Cell Lung Cancer: Correlation with the Response to Gefitinib Therapy.: Jinyoung Yoo, Kyungji Lee, Ji Han Jung, Byoung Yong Shim, Sung Hwan Kim, Deog Gon Cho, Myeong Im Ahn, Chi Hong Kim, Kyu Do Cho, Hoon Kyo Kim, Seok Jin Kang; Korean J Pathol. 2008;42(1):1-8.

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Abstract PDF: BACKGROUND
Gefitinib is an EGFR tyrosine kinase inhibitor that has shown dramatic effectiveness in a subset of non-small cell lung cancer (NSCLC) patients. We evaluated the response rate to gefitinib, and the significance of the EGFR and HER2/neu status as predictive markers of the tumor response.
METHODS
The EGFR and HER2/neu protein expressions, as determined by immunohistochemistry (IHC) and gene amplification via chromogenic in situ hybridization (CISH), were analyzed in biopsy specimens from 46 patients with advanced NSCLC. After their failure with the first-line treatment, all the patients had received gefitinib treatment.
RESULTS
A partial response (PR) was achieved in 8 patients (17.4%). An EGFR overexpression was detected in 80.4% (37/46) of the tumors, and this was observed exclusively in patients with a PR (100% vs 75.3%, respectively; p=0.076). EGFR gene amplification was present in 47.8% of the tumors (22/46). HER2/neu was overexpressed in 13%(6/46) and it was amplified in 17% (7/46). The overall survival was prolonged in the female patients (p=0.007), and in patients with T1 and T2 disease (p=0.039), adenocarcinoma (p=0.010), a PR (p=0.022), an EGFR IHC+ status (p=0.033), an EGFR IHC+/CISH+ status (p=0.010), or an EGFR+/HER2/neu+ status (p=0.030). On multivariate analysis, gender, T disease and EGFR IHC/CISH remained the significant predictors of survival.
CONCLUSIONS
Gefitinib showed a modest effect for the patients with chemotherapy-refractory advanced NSCLC. A combination of EGFR IHC and CISH might be important for identifying those patients who are most likely to benefit from gefitinib therapy.

Epidermal Growth Factor Receptor Overexpression and the Tumor Response to Preoperative Radiochemotherapy for Patients with Advanced Rectal Cancer.: Jinyoung Yoo, Ju Won Chyung, Ji Han Jung, Hyun Joo Choi, Seok Jin Kang, Kyo Young Lee; Korean J Pathol. 2007;41(5):316-323.

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Abstract PDF: BACKGROUND
An association between the epidermal growth factor receptor (EGFR) signaling pathway and the response of cancer cells to ionizing radiation has been previously described. Preoperative radiochemotherapy (PRCT) has been administered for treating locally advanced rectal cancer to improve the outcomes, and to preserve the sphincter from lowlying tumor. However, the responses of tumors to PRCT are variable and there are currently no reliable markers that predict the therapeutic benefits. We studied the association between EGFR overexpression and the tumor response to PRCT in rectal cancer.
METHODS
The EGFR protein expression, as determined by immunohistochemistry, was analyzed in the pretreatment biopsy specimens from 120 patients with advanced rectal cancer. The tumor response was graded in the surgically resected specimens by using a three-scale grading system: no response (NR), partial remission (PR) and complete remission (CR).
RESULTS
NR was identified in 70 cases (58.3%). Fifty patients (41.7%) responded to PRCT; 27 (22.5%) achieved a PR and 23 (19.2%) achieved a CR. EGFR overexpression was detected in 78 (65%) cases. Seventy-eight percent (39/50) of the tumors with a CR/PR revealed EGFR reactivity, whereas 55.7% (39/70) of the tumors with NR showed an EGFR expression (p=0.048).
CONCLUSIONS
The EGFR protein expression might be a valuable marker for identifying those patients who are most likely to benefit from PRCT.

Expression of Claudin-1 and -4 in Benign Lesions and Invasive Ductal Carcinomas of the Breast.: Hyun Joo Choi, Ji Han Jung, Jinyoung Yoo, Seok Jin Kang, Kyo Young Lee; Korean J Pathol. 2007;41(4):232-237.

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Abstract PDF: BACKGROUND
The claudins are a family of transmembrane proteins associated with tight junctions and they are critical for maintaining cell-to-cell adhesion in sheets of epithelial cells. However, their role in the progression of cancer remains largely unexplored. The aims of this study were to evaluate the expression patterns of claudin-1 and -4 in benign lesions and invasive ductal carcinomas (IDC) of the breast, and relationships between the expression of these markers and the clinicopathological characteristics in IDC patients.
METHODS
We examined the claudin-1 and -4 protein expressions by performing immunohistochemical stainings in 54 benign lesions and 120 IDCs via the tissue microarray method. We evaluated the correlation between the expression of these markers and the clinicopathological characteristics of IDC.
RESULTS
The expressions of claudin-1 (p=0.099) and -4 (p=0.000) were up-regulated in IDCs as compared with benign lesions. The claudin-1 expression correlated with the loss of estrogen receptor (p=0.036) and progesterone receptor (p=0.011). The claudin-4 expression correlated with lymph node metastasis (p=0.043), the nuclear grade (p=0.030), the histologic grade (p=0.007), and the loss of estrogen receptor (p=0.001) and progesterone receptor (p= 0.029).
CONCLUSIONS
These results suggest that claudin-1 and -4 may play a significant role in the carcinogenesis of IDC of the breast and these may represent novel markers for this disease.

Expression of Survivin According to Malignant Progression of Breast Lesions.: Hyun Joo Choi, Ji Han Jung, Chan Kwon Jung, Jinyoung Yoo, Eun Jung Lee, Chang Suk Kang, Seok Jin Kang, Kyo Young Lee; Korean J Pathol. 2007;41(4):238-243.

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Abstract PDF: 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.

An Unusual Stroma-Rich Variant of Castleman's Disease of the Hyaline-Vascular Type: A Case Report.: Ji Han Jung, Gyeongsin Park, Hyun Joo Choi, Jinyoung Yoo, Seok Jin Kang, Kyo Young Lee; Korean J Pathol. 2007;41(4):266-270.

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Abstract PDF: The stroma-rich variant of Castleman's disease of the hyaline-vascular type (CDHV) is a rare entity that shows overgrowth of a variety of stromal cells in the widened interfollicular (IF) area. We report here on a case of a stroma-rich variant of CDHV in an 18-year-old man who presented with an asymptomatic solitary neck mass he'd had for 1 year. Histologically, an enlarged lymph node fulfilled the criteria of CDHV, along with vague nodularity of a widened IF area. The nodular lesion consisted of numerous vessels and a proliferation of spindle cells. Immunohistochemically, the spindle cells were positive for vimentin and smooth muscle actin, they were negative for desmin, CD21, CD34, CD68, ALK-1, and S-100 protein. This stromal lesion is typically hyperplastic and clinically benign, and it must be distinguished from neoplastic stromal proliferation associated with Castleman's disease because of its potential for recurrence and metastasis.

Trichoblastic Carcinoma arising in Trichoblastoma: A Case Report.: Kyung Jin Seo, Jinyoung Yoo, Seok Jin Kang, Ji Han Jung, Hye Kyung Lee, Kyo Young Lee; Korean J Pathol. 2007;41(4):274-277.

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Abstract PDF: Trichoblastic carcinoma is a rare malignant neoplasm of follicular germ cell origin; to the best of our knowledge, only six trichoblastic carcinomas arising in trichoblastomas have appeared on the literature. We recently experienced a trichoblastic carcinoma arising in a long standing trichoblastoma. A 68-year old woman came to the hospital with a chief complaint of an ulcerated nodule on her face. The nodule, 1.1x0.9 cm with an asymmetrical configuration, had been present and unchanged for more than 20 years, however, it grew suddenly with painful burning sensation. An excisional biopsy was performed and disclosed a deeply invasive, highgrade carcinoma, which consisted of cohesive epithelial cells arranged in irregular plump or germinative cell nests of various sizes. However, at the periphery of the tumor was a benign trichoblastoma surrounded by perifollicular sheath. We believe that the present case is a trichoblastic carcinoma developed via malignant transformation of pre-existing trichoblastoma.

Pigmented Trichogerminoma: A Case Report.: Jung Ha Shin, Ji Han Jung, Jinyoung Yoo, Seok Jin Kang, Kyo Young Lee; Korean J Pathol. 2007;41(3):187-189.

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Abstract PDF: Trichogerminoma is a rare cutaneous adnexal tumor that dysplays differentiation toward the hair germ epithelium. This tumor was first described by Sau et al. in 1992 and it is characterized by densely packed round nests or cell balls resembling hair bulbs. Herein, we report on a deeply pigmented and sharply circumscribed nodular tumor that was excised on the abdomen of a 48-year-old woman. Histologically the tumor involved both dermis and subcutis without any epidermal connection. The main nodule was subdivided into the smaller lobules by fibrous stroma. The lobules were composed of masses of basaloid cells that displayed peripheral palisading. Within the lobules, the basaloid cells formed numerous cell balls. The tumor presented the characteristic features of trichogerminoma. Interestingly, our case was the pigmented type, which was remarkable by virtue of the heavy melanin deposits found within and around the tumor nests. To the best of our knowledge, this is the first case of pigmented trichogerminoma that has been reported worldwide.

The Expression of Telomerase Reverse Transcriptase Protein is an Independent Prognostic Marker in Early Stage Non-Small Cell Lung Carcinomas.: Ji Han Jung, Chan Kwon Jung, Ahwon Lee, Gyeongsin Park, Jinyoung Yoo, Kyo Young Lee; Korean J Pathol. 2007;41(2):95-102.

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Abstract PDF: BACKGROUND
The catalytic subunit of telomerase, hTERT (telomerase reverse transcriptase), is one of the most important components of telomerase, and performs a pivotal role in the mechanism underlying the regulation of telomerase activity in cellular immortalization and carcinogenesis. The principal objective of this study was to investigate hTERT expression in patients with non-small cell lung carcinomas (NSCLCs), and to evaluate its clinical significance and association with the expression of p16 and p53.
METHODS
Using tissue microarray, the protein expression profiles of hTERT, p16 and p53 were investigated via immunohistochemistry in 167 samples of NSCLCs.
RESULTS
Expression was observed in 54.5% (91/167) of the tumors, which were predominantly squamous cell carcinomas. Patients evidencing hTERT expression in their tumors exhibited significantly poorer survival rates than did patients without hTERT expression in early-stage NSCLCs (p=0.0125). According to the results of our Cox regression analysis, hTERT expression proved to be an independent prognostic factor (p=0.006), particularly for squamous cell carcinomas (p=0.019). hTERT expression was not correlated with p16 expression, but was rather associated with the expression of p53 (p=0.002).
CONCLUSIONS
Our results show that hTERT may perform a function in the progression of NSCLC, and that its detection may be useful in predicting the prognosis of NSCLC patients in the early stages of the disease, as well as in the development of a targeted therapy in these tumors.

Expression of p73 in Non-small Cell Lung Carcinomas.: Ji Han Jung, Gyeongsin Park, Chan Kwon Jung, Hyun Joo Choi, Jinyoung Yoo, Seok Jin Kang, Kyo Young Lee; Korean J Pathol. 2007;41(2):109-115.

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Abstract PDF: BACKGROUND
The p73 is a recently identified homologue of the tumor suppressor gene, p53, and it has been found to induce apoptosis and inhibit cell proliferation. However, its role in the development of tumors is unclear. This study examined the expression of p73 in patients with non-small cell lung carcinomas (NSCLCs) to determine its clinical significance and association with the expressions of p53, pRb, and mdm2.
METHODS
A total of 183 NSCLCs were analyzed immunohistochemically using a tissue microarray.
RESULTS
The p73 protein was expressed in the cell nuclei in 156 (85.2%) out of the 183 cases. There was no correlation between the p73 expression and the clinicopathological variables. However, there was a correlation between the p73 expression and the mdm2 and pRb expressions. Multivariate Cox survival analysis identified tumor size and lymph node metastasis to be independent prognostic factors, but the p73 expression was not found to be associated with the patients' survival.
CONCLUSIONS
p73 is commonly expressed in NSCLC and it might, in conjunction with pRb and mdm2, be involved in the development of these tumors.

Intra-thyroid Thyroglossal Duct Cyst: A Case Report.: Hyun Joo Choi, Ji Han Jung, Jinyoung Yoo, Seok Jin Kang, Kyo Young Lee, Chung Soo Chun, Bong Joo Kang, Eun Suk Cha; Korean J Pathol. 2007;41(2):132-134.

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Abstract PDF: Thyroglossal duct cysts develop in the persistent remnants of the thyroglossal tract between the origin of the thyroid at the foramen cecum and the final position of the thyroid gland. Thyroglossal duct cyst can present anywhere from the base of the tongue to the manubrium, but its occurrence within the thyroid gland is very rare. We report here on a 41-year-old woman who presented with a cystic thyroid nodule that was due to an intrathyroid thyroglossal duct cyst. The sonogram, showed a hypoechoic nodule that measured 0.7 x 0.6 cm in the left thyroid lobe. Left lobectomy of the thyroid gland was performed and microscopic examination revealed a cyst lined by non-keratinized squamous epithelium, which was consistent with a thyroglossal duct cyst in the thyroid gland. Intrathyroid thyroglossal duct cyst should be considered in the differential diagnosis of a cystic thyroid nodule. This is the first reported case of a intrathyroid thyroglossal duct cyst in a Korean adult.

Fine Needle Aspiration Cytology of Invasive Micropapillary Carcinoma of the Breast.: Hyun Joo Choi, Ji Han Jung, Jung Ha Shin, Kiouk Min, Jinyoung Yoo, Seok Jin Kang, Kyo Young Lee; Korean J Cytopathol. 2007;18(1):62-68.

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Abstract PDF: Invasive micropapillary carcinoma (IMPC) of the breast is recently described rare variant of invasive ductal carcinoma. This variant has a distinctive histological features and aggressive biological behavior. We reviewed the cytologic features of eight cases of IMPC. The cytologic smears showed moderate to high cellularity and the tumor tissue was composed of atypical, angulated, cohesive clusters of neoplastic cells with a papillary to tubuloalveolar architecture, and a morular growth pattern without fibrovascular cores was seen on the histopathology. IMPC of the breast has distinctive cytologic features and it is important to make an early diagnosis via fine needle aspiration cytology due to this tumor's aggressive behavior.

Ectopic Sebaceous Glands in the Esophagus: A Case Report.: Jung Ha Shin, Ji Han Jung, Hyun Joo Choi, Jinyoung Yoo, Seok Jin Kang, Kyo Young Lee; Korean J Pathol. 2006;40(6):448-451.

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Abstract PDF: There are few reports of the endoscopic and histological features of ectopic sebaceous glands in the esophagus. Recently we observed a 2 mm whitish flat elevated nodule in the lower esophagus. A biopsy was taken under the clinical impression of a papilloma or ulcer scar. Histology revealed normal esophageal mucosa with mature ectopic sebaceous glands located in the lamina propria with no visible hair follicles. We report this case with a brief review of the literature related to the histological findings and histogenesis of esophageal ectopic sebaceous glands.

Expression of Cell Cycle-Regulatory Proteins in Rectal Cancer: Significance of the Tumor Response to Preoperative Radiochemotherapy and for the Prognosis.: Jinyoung Yoo, Jung Ha Shin, Ji Han Jung, Hyun Joo Choi, Seok Jin Kang, Chang Suk Kang, Kyo Young Lee; Korean J Pathol. 2006;40(3):217-224.

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Abstract PDF: BACKGROUND
Preoperative radiochemotherapy (PRCT) improves the outcomes for patients suffering with locally advanced rectal carcinoma, compared with surgery alone. However, there are no reliable factors predicting the survival and therapeutic benefits.
METHODS
The cell-cycle regulatory proteins were investigated in the pretreatment biopsies from 68 patients who were suffering with rectal cancer by performing immunohistochemical studies of p53, p21, cyclin D1, Rb and p16 protein. The tumor response was graded on a three-scale grading system: no response (NR), partial remission (PR) and complete remission (CR).
RESULTS
The tumors were positive for p53, p21 and cyclin D1 in 46 (67.6%), 32 (47.1%) and 14 (20.6%) cases, respectively. Abnormalities in Rb immunostaining were observed in 9 (13.2%) cases, while an abnormal p16 expression was noted in 59 (86.8%) tumors. Forty-two patients (61.8%) responded to PRCT: 18 (26.5%) cases achieved a CR and 24 (35.3%) cases achieved a PR. None of the above molecular markers were significantly associated with tumor response. However, the altered expression of p16 showed a significant correlation with overall survival (p=0.001). The high expression of p21 demonstrated a trend for longer survival (p=0.061).
CONCLUSIONS
Of the cell-cycle regulatory proteins, p16 may be a valuable marker for to predict rectal cancer patients' survival; however, the role of each cell-cycle regulatory protein for the therapeutic benefits of PRCT needs to be further studied.

Fine Needle Aspiration Cytological Findings of Angioimmunoblastic T-cell Lymphoma : A Brief Case Report.: Ji Han Jung, Hyun Joo Choi, Jinyoung Yoo, Seok Jin Kang, Chang Suk Kang, Kyo Young Lee; Korean J Cytopathol. 2006;17(2):159-161.

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Abstract PDF: Recently, we experienced a case of Angioimmunoblastic T-cell lymphom (AITL) in a 60-year-old man presented with lymphadenopathy, which is first cytological report in Korea. The cytological features showed a heterogeneous population of small to medium-sized lymphocytes, immunoblasts, and plasma cells. Characteristically, there were also a distinct population of follicular dendritic cells admixed with lymphoid cells, forming the so-called dendritic cell-lymphocyte complexes. Histological features showed the classic morphologic features of AITL. Recognition of the characteristic cytological features can suggest the possibility of AITL.

The Expression of Matrix Metalloproteinase-9 and Tumor Angiogenesis in Human Osteosarcoma.: Jinyoung Yoo, Ji Han Jung, Hyun Joo Choi, Seok Jin Kang, Anhi Lee, Eun Joo Seo, Sang In Shim, Chang Suk Kang; Korean J Pathol. 2005;39(6):418-423.

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Abstract PDF: BACKGROUND
Matrix metalloproteinase-9 (MMP-9) is a matrix-degrading enzyme that's believed to play a crucial role not only for tumor invasion and metastasis, but also for a variety of stromal reactions, including neovascularization. The aim of this study was to investigate the expression of MMP-9 and to compare its expression with the angiogenesis activity in human osteosarcoma.
METHODS
Archival tumor tissue samples from 20 patients with osteosarcoma were analyzed by performing immunohistochemistry for the expression of MMP-9 and CD34. The vascularity was measured as the average microvascular density (MVD) of the CD34-positive vessels. The clinical information was obtained through searching the computerized retrospective database from the tumor registry.
RESULTS
MMP-9 was expressed in 90% (18/20) of the tumors we examined. The MVD ranged from 10.5 to 179.7 with a mean of 64.9. There was no significant correlation between the MMP-9 expression and the MVD (p=.613). The MMP-9 expression was not associated with any of the clinicopathologic variables, whereas the MVD showed an increasing tendency according to the metastasis status (p=.073).
CONCLUSIONS
We demonstrated that MMP-9 activation is likely to occur in human osteosarcoma. However, there was no direct involvement of MMP-9 with tumor angiogenesis. It is noteworthy that MVD may aid physicians to predict the presence of distant metastasis in osteosarcoma patients.

Expression of Thymidylate Synthase in Non-Small Cell Lung Cancer.: Jinyoung Yoo, Suzi Kim, Byoung Yong Shim, Sung Hwan Kim, So Hyang Song, Deog Gon Cho, Meyung Im Ahn, Chi Hong Kim, Kyu Do Cho, Seok Jin Kang, Hoon Kyo Kim; Korean J Pathol. 2005;39(6):412-417.

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Abstract PDF: BACKGROUND
Thymidylate synthase (TS) catalyzes the methylation of deoxyuridine monophosphate (dUMP) to deoxythymidine monophosphate (dTMP), and this is an essential step in DNA biosynthesis. The present investigation was designed to determine the expression of TS in the patients with non-small cell lung cancer (NSCLC) and to assess the possible associations between the TS status and the p53 or proliferative index (PI).
METHODS
The archival tumor tissues from 56 previously untreated NSCLC patients were examined by immunohistochemistry for TS, p53 and Ki-67.
RESULTS
Forty-one men and 15 women (age range: 35 to 79 years, mean age: 62 years) were included in this study. The TS expression was high in 40 patients (71.4%) and low in 16 patients (28.6%). The aberrant expression of p53 was detected in 35 patients (62.5%). The mean PI for all the patients was 31.4+/-12.1. The TS-high tumors tended to be more poorly differentiated (p=0.069). The TS expression by a semiquantitative fourscale grading system was significantly correlated with the PIs (p=0.003). No correlation was established between the TS expression and the p53 status (p=0.806) or survival (p=0.951). CONCLUSIONS: TS was not confirmed to be a useful marker for determining the prognosis of NSCLC patients. However, our data suggest that the tumor cells with higher TS expression have a higher proliferative activity.

An Analysis of p53, bcl-2 and Ki-67 Expressions, and Apoptosis in Rectal Cancer: Their Correlation with the Tumor Response after Preoperative Radiochemotherapy.: Jinyoung Yoo, Su Zy Kim, Hyeon Min Cho, Sung Whan Kim, Hyung Min Chin, Jung Yong Lee, Jun Ki Kim, Seok Jin Kang, Chung Soo Chun, Chang Suk Kang; Korean J Pathol. 2005;39(4):222-228.

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Abstract PDF: Background
: Preoperative radiochemotherapy (RCT) has been administered for locally advanced rectal cancer to increase the therapeutic benefits, and to preserve the sphincter in low-lying tumors, however, tumor responses after RCT are variable. Methods : Apoptotic index (AI), and expressions of Ki-67, p53 and bcl-2 were analyzed in pretreatment biopsies from 69 patients with rectal cancer by immunohistochemistry. Tumor response was graded in surgically resected specimens by using a three-scale grading system: no response (NR), partial remission (PR) and complete remission (CR). Results : CR was identified in 19 cases (28%), PR in 24 cases (35%), and NR in 26 cases (38%) of 69 cases. p53 protein was expressed in 49 cases (71%), whereas bcl-2 was in 42 cases (61%). The pretreatment Ki-67 labeling index was 65.4+/-3.4%. The tumor response was not associated with any of these markers. Tumors with CR/PR showed a higher AI (0.84+/-.84%/0.66+/-.52%) than that of tumors with NR (0.58+/-0.54%). There was a significant correlation between tumor response and the histologic differentiation (p=0.008) or recurrence (p=0.039). Conclusions : The AI revealed a tendency to increase in tumors with CR/PR, while expressions of p53 and bcl-2, and Ki-67 labeling index had little direct association with tumor response.

Actinomycosis of the Intrahepatic Bile Duct, Superimposed on Hepatolithiasis: A Case Report.: Ji Han Jung, Hyun Joo Choi, Jinyoung Yoo, Seok Jin Kang, Chang Suk Kang; Korean J Pathol. 2005;39(2):140-144.

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Abstract PDF: Actinomycosis is a chronic suppurative infection caused by Actinomyces, a filamentous, grampositive, anaerobic bacterium that is a normal inhabitant of the oral cavity and gastrointestinal tract. Actinomycosis of the biliary duct is very rare and the pathogenesis of this infection is poorly understood. We report here on a case of actinomycosis in the intrahepatic bile duct that was superimposed on hepatolithiasis. A 55-year-old woman presented with epigastric discomfort and episodic upper abdominal pain for 1 year. The radiologic findings revealed multiple hepatolithiasis and cholelithiasis. On performing left lateral segmentectomy of the liver, the markedly dilated intrahepatic bile duct contained several brown pigmented stones, and periductal chronic inflammation with fibrosis and proliferation of the bile ductules were observed. In addition to the intrahepatic stones, there were sulfur granules with neutrophilic infiltration and necrotic debris. The gram stain and methenamine silver stain revealed tangled filamentous and branching bacteria, which were consistent with Actinomyces. Acid-fast staining result was negative and no malignancy was detected.

Expression of bcl-2, p53 and VEGF in Non-Small Cell Lung Carcinomas: Their Relation with the Microvascular Density and Prognosis.: Jinyoung Yoo, Ji Han Jung, Hyun Joo Choi, Seok Jin Kang, Chang Suk Kang; Korean J Pathol. 2005;39(2):74-80.

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Abstract PDF: BACKGROUND
The aim of this study was to investigate the expression of bcl-2, p53 and vascular endothelial growth factor (VEGF) in non-small cell lung cancer (NSCLC), and to examine the relationship between those protein expressions and neovascularization. We also analyzed the prognostic impact of these biological parameters on the patients' overall survival rate.
METHODS
The archival tumor tissues from 147 previously untreated patients with NSCLC were examined by immunohistochemistry for bcl-2, p53 and VEGF proteins. The vascularity was measured by the average microvascular density (MVD) of the CD34-positive vessels. Clinical information was obtained through the computerized retrospective database from the tumor registry.
RESULTS
Immunoreactivity for bcl-2 was detected in 17% (25/147), p53 in 72% (106/147) and VEGF in 75% (110/147) of the tumors. An inverse association was found between bcl-2 expression and VEGF expression (p=0.012). There was a significant correlation between the bcl-2 expression and the MVD (p=0.009), and also between the p53 expression and the MVD (p=0.045). The mean survival time was associated with the patients' age (p=0.032), the T status (p=0.038), the tumor stage (p=0.009), and expressions of bcl-2 (p=0.016) and VEGF (p=0.039). On multivariate analysis, only the tumor stage and VEGF expression maintained their prognostic influence.
CONCLUSIONS
Our data suggest that bcl-2 and p53 alterations are involved in the angiogenesis of NSCLC, and are either dependent on or independent of VEGF. It is further noteworthy that the tumor stage and VEGF expression may be useful in predicting patients' survival.

Expressions of p130Cas and FHIT, and Their Relationships with Prognostic Factors for Breast Carcinomas.: Hyun Joo Choi, Ji Han Jung, Jinyoung Yoo, Seok Jin Kang, Chang Suk Kang; Korean J Pathol. 2005;39(1):41-47.

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Abstract PDF: BACKGROUND
BCAR1/p130Cas protein is the human homologue of rat p130Cas protein, and it is a docking protein involved in the intracellular signaling pathways. This protein also causes the proliferating human breast cancer cells to be resistant to antiestrogen drugs. The fragile histidine triad (FHIT) protein is presumed to have a tumor suppressor function in a number of human tumors. The aim of this study was to investigate expressions of p130Cas and FHIT in breast carcinomas and to evaluate their relationship with the clinicopathological prognostic factors.
METHODS
A total of 93 cases of invasive breast carcinomas was retrospectively reviewed. The expressions of p130Cas and FHIT were examined by immunohistochemical methods.
RESULTS
p130Cas expression was observed in all breast carcinomas: p130Cas immunoreactivity was strongly positive in 39 cases (41.9%), moderately positive in 49 cases (52.7%) and weakly positive in 5 cases (5.4%) of 93 cases. It was statistically correlated with the p53 (p=0.035) and c-erbB-2 (p=0.024) expressions. The FHIT protein expression was markedly reduced or completely negative in 59 cases (63.4%), but it was not correlated with the clinicopathological prognostic factors. There was no significant correlation between p130Cas and FHIT expressions.
CONCLUSIONS
This study seems to provide meager information on whether these proteins may be useful prognostic factors, and so this topic needs further study.

Tissue Microarray Analysis of the Expression of p53, c-kit and CD34 in Sarcomas.: Jinyoung Yoo, Kyung Shin Park, Seok Jin Kang, Chang Suk Kang; Korean J Pathol. 2004;38(4):221-227.

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Abstract PDF: BACKGROUND
Our objectives in this study were to (1) evaluate the possible role of p53, c-kit and CD34 proteins in sarcomas and to determine their potential relationship; (2) use a tissue microarray to compare the immunohistochemical staining results on both the tissue microarrays and the corresponding whole tissue sections.
METHODS
Whole sections from 85 sarcomas were studied for the immunohistochemical expression of p53, c-kit and CD34. Tissue microarrays consisting of triplicate 2 mm cores from the corresponding blocks were constructed and stained according to the same protocols as those used for the whole sections.
RESULTS
On whole section analysis, p53 protein was expressed in 25 cases (29.4%). Expression of c-kit was observed in 31 specimens (36.5%), whereas CD34 expression was noted in 11 tumors (12.9%). The overall concordance between triplicates was 96% (217/226). The consensus score from the combined triplicates agreed with the results on the whole sections at 91.4% (233/255). The correlations between p53 and CD34, and between c-kit and CD34, were statistically significant (p=.028 and p=.010 respectively).
CONCLUSIONS
p53 and c-kit express relatively frequently in sarcomas. Tissue microarrays are an effective alternative to whole sections; however, the presence of triplicate punches seems to improve the yield but not the concordance of data.

Conjunctival Pigmented Actinic Keratosis: A Case Report.: Jinyoung Yoo, Ji Han Jung, Hyun Joo Choi, Seok Jin Kang, Chang Suk Kang; Korean J Pathol. 2004;38(2):113-115.

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Abstract PDF: We recently had a case of pigmented actinic keratosis arising in the conjunctiva, and this is an unusual site for the lesion. Most actinic keratoses are seen on sun-exposed areas of the skin, especially for Caucasians living in sunny climates. When these lesions are pigmented, they may resemble lentigo maligna. A 56-year-old man was referred to the ophthalmology clinic for a pigmented conjunctival lesion. An ophthalmologic examination revealed multiple dark brown-colored, linear or irregular shaped patches located on the lateral side of the conjunctiva in his right eye, partially covering the cornea, and this made a clinical differentiation from other possible pigmented lesions somewhat difficult. A histologic examination of the subsequent biopsy specimen demonstrated acanthosis with melanocytes containing heavy melanin, scattered dyskeratotic cells, atypical keratinocytes, and solar elastosis, and all of their findings are consistent with pigmented actinic keratosis.

Expression of FHIT and p21 in Gastric Adenocarcinoma.: Hyun Joo Choi, Byung Kee Kim, Jinyoung Yoo, Seok Jin Kang, Chang Suk Kang; Korean J Pathol. 2004;38(1):35-41.

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Abstract PDF: BACKGROUND
The fragile histidine triad (FHIT) gene, located on the human chromosome 3p14.2, is frequently inactivated by its deletion in a number of human tumors, including gastric carcinomas. Its protein product, FHIT is presumed to have a tumor suppressor function. p21, one of the tumor markers acts as a regulator of the cell cycle, and inhibits cell proliferation.
METHODS
The association of the expressions of FHIT and p21 protein, with clinicopathological features, such as age, gender, tumor size, histological type, depth of invasion, lymph node metastasis, lymphatic and vascular invasion, grade and stage were investigated, and correlation of their expressions with p21 expression in 82 gastric adenocarcinomas attempted by immunohistochemical staining.
RESULTS
Of the 82 tumors analyzed, 58 (70.7%) were markedly reduced, or completely negative, for FHIT protein expression. The loss of FHIT expression was correlated with the depth of invasion (p=0.000), lymph node metastasis (p=0.001), lymphatic invasion (p=0.000), histological grade (p=0.000) and tumor stage (p=0.000). The loss of p21 expression was correlated with lymph node metastasis (p=0.026) and lymphatic invasion (p= 0.017), but not with the histological grade and tumor stage. The comparison of the FHIT and p21 protein expressions showed significant correlation (p=0.035).
CONCLUSIONS
The loss of FHIT and p21 expressions may be a useful indicator of the post diagnostic prognosis. Also, FHIT could be related to cell cycle arrest.

Squamous Cell Carcinoma Developed in Nevus Sebaceus: A Case Report.: Hyun Joo Choi, Jinyoung Yoo, Lee So Maeng, Seok Jin Kang, Chang Suk Kang; Korean J Pathol. 2004;38(1):60-63.

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Abstract PDF: We report a case of squamous cell carcinoma developed within the nevus sebaceus (NS) and review the literature. An 82-year-old woman presented with a 3-month history of pain within the lifelong skin lesion on her right cheek. Examination revealed a 1.0 x 1.0 cm poorly marginated, slightly raised yellow-brown nodule. Microscopically, the skin nodule revealed the typical findings of NS. Squamous cell carcinoma developed contiguously within the keratin-filled infundibulocyst of NS disconnected from the epidermis. We suggest that squamous cell carcinoma is derived from the embryonal stratum germinativum de-differentiated from the primary epithelial germ cells in the infundibulocyst of NS. Most secondary carcinomas associated with NS grow slowly over a period of years. In contrast, squamous cell carcinoma developed in NS often grow rapidly with aggressive behavior. Thus, the accurate pathologic diagnosis is necessary.

Eccrine Syringofibroadenoma: A Case Report.: Hee Jeong Lee, Jinyoung Yoo, Seok Jin Kang, Byung Kee Kim, Chang Suk Kang; Korean J Pathol. 2003;37(4):298-299.

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Abstract PDF: Eccrine syringofibroadenoma is an uncommon benign eccrine tumor, which was first described by Mascaro in 1963. It usually develops on the extremeties of elderly persons. Recently we experienceda case of eccrine syringofibroadenoma that occured in a 38-year-old woman. She presentedus an asymptomatic solitary reddish nodular plaque with a verrucous surface, whichshe'd had on her right arm for three months. Histologically, slender anastomosing epithelial cellcords with focal luminal differentiation resembling duct structures were embedded in a fibrovascularstroma. The net-like pattern of epithelial cells resembled that seen in fibroepithelioma.

Metastasizing Atypical Chondroid Lesion: A Case Report.: Heejeong Lee, Jinyoung Yoo, Seok Jin Kang, Byung Kee Kim; Korean J Pathol. 2003;37(1):62-65.

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Abstract PDF: We recently experienced an atypical chondroid lesion metastatic to the lung. Examined under the microscope, the excised nodules displayed abundant amounts of chondroid tissue and necrosis with dystrophic calcification. The calcification had a characteristic "chicken wire" pattern. The chondroblasts contained one or two round to oval, focally indented nuclei with inconspicuous nucleoli. Although some enlarged nuclei with mild to moderate pleomorphism were present, significant nuclear atypia was lacking. Mitotic figures were scarce (1/10 high power field). Scattered multinucleated osteoclast-type giant cells were observed among the chondroblasts. Thus, the possibility of chondroblastoma was considered first. Metastasis of histologically benign chondroblastoma is a rare event, but well documented. The pulmonary metastatic nodules were described as ceasing to grow in some cases; and a significant number of patients were free of tumors following removal of the metastatic nodules. These findings suggest that the metastasis may represent a simple transport phenomenon. However, there are, as yet, no histologic parameters that help determine whether these metastases are to cease their growth or will progress to kill the host.

Primary Leiomyosarcoma of Adrenal Gland: A Case Report.: Heejeong Lee, Jinyoung Yoo, Seok Jin Kang, Byung Kee Kim; Korean J Pathol. 2002;36(3):191-194.

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Abstract PDF: Primary mesenchymal neoplasm of the adrenal gland is very rare. Recently we experienced a case of leiomyosarcoma of the adrenal gland in a 47-year-old female patient. The resected adrenal gland showed a large lobulated mass, which replaced the entire gland. The cut surface was firm and whitish gray with foci that showed hemorrhage and necrosis. Histologically, the tumor was composed of intersecting fascicles of pleomorphic spindle cells with numerous giant cells and mitotic figures. Some of the tumor cells showed elongated nuclei. Immunohistochemical studies were strongly positive for vimentin and smooth muscle actin. Cytokeratin, desmin, alpha-1-antitrypsin and lysozyme were all negative. To the best of our knowledge, this is the first case reported in Korea.

Ras Gene Mutations and Expression of ERK1 and ERK2 Proteins in Stomach Cancer.: Jinyoung Yoo, Seok Jin Kang, Byung Kee Kim, Chang Suk Kang; Korean J Pathol. 2002;36(2):77-83.

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Abstract PDF: BACKGROUND
We investigated stomach cancers for ras abnormalities and expression of ERK1 and ERK2 to determine their significance in the tumor development and/or progression and to evaluate their potential correlation with clinicopathologic parameters.
METHODS
Seventy gastric adenocarcinomas were studied immunohistochemically in paraffin-embedded tissue sections for the expression of ERK1 and ERK2 proteins. All tumors were further analyzed with the use of a polymerase chain reaction technique and a direct sequence analysis procedure for the presence of the mutated ras gene.
RESULTS
ERK1 and/or ERK2 was expressed in 65.7% (46/70) of the tumors; overexpression of ERK1 was observed in 38 (54.3%) tumors, whereas ERK2 was detected in 29 (41.4%). Nine (12.8%) samples demonstrated multations in the ras gene: 4 in H-ras and 5 in K-ras. Seven of the 9 (77.8%) mutated tumors were of the intestinal type. No association was established between the ras abnormalities and the overexpression of ERK1 and/or ERK2. However, the correlation between ERK2 and progression (early vs. advanced) was statistically significant (p<0.05).
CONCLUSIONS
These data indicate that ras abnormalities are uncommon events in gastric adenocarcinomas. The majority of ras mutations, however, occurred in intestinal-type tumors, supporting the notion of different molecular mechanisms involved between the intestinal-and diffuse-type lesions. Enhanced ERK2 activity may provide assistance in the determination of tumor penetration in these tumors.

Expression of Cyclin D1, CDK4, p16 and Rb Proteins in Human Soft Tissue Sarcomas.: Jinyoung Yoo, Ah Won Lee, Seok Jin Kang, Byung Kee Kim; Korean J Pathol. 2001;35(3):238-244.

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Abstract PDF: BACKGROUND
Altered cell cycle regulation may underlie the development and/or progression of human malignancies. The purpose of this study is to determine if the oncogenesis of soft tissue sarcomas could be better explained by examining the components involved in G1 phase progression.
METHODS
Sixty-seven soft tissue sarcomas were studied for the immunohistochemical expression of cdk4, cyclin D1, retinoblastoma (Rb) and p16 proteins. For Rb and p16, samples showing either negative or heterogeneous (<80% of tumor cells) staining were considered to be altered.
RESULTS
The cdk4 protein was observed in 64 cases (95.5%). Cyclin D1 was expressed in 14 cases (20.9%). The Rb expression was altered in 48 (71.6%). Sixty-three (94%) sarcomas demonstrated altered p16 expressions. All of the samples displayed altered expressions of either Rb or p16. A high percentage of the tumors with altered Rb were observed in relapsed patients (p<0.05).
CONCLUSIONS
Disturbance in the cell cycle regulatory system involving the Rb/p16/cdk4/cyclin D1 pathway appears to be relatively frequent in soft tissue sarcomas and may play an important role in the tumorigenesis of these tumors. It is noteworthy that the reduced Rb expression correlates with tumor relapse, suggesting its prognostic significance.

ras Gene Mutations in Malignant Fibrous Histiocytoma.: Jinyoung Yoo, Ah Won Lee, Seok Jin Kang, Byung Kee Kim; Korean J Pathol. 2001;35(3):232-237.

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Abstract PDF: BACKGROUND
ras gene mutations have been described in various human malignancies, suggesting that their activation may play a role in oncogenesis. However, there are few reports concerning ras gene alterations in malignant fibrous histiocytomas. We therefore designed a study to determine the prevalence and type of mutations in the first exons of H-ras and K-ras genes in these tumors.
METHODS
Twenty-seven malignant fibrous histiocytomas were investigated by direct sequencing analysis with the automated DNA sequencing of polymerase chain reaction-amplified ras sequences.
RESULTS
Twenty-four mutations were found in 18 (67%) of the tumors: GGC to GAC transition mutations at codon 13 of K-ras (coding for aspartic acid instead of glycine) in 18 of the samples and GGC to GTC transversions at codon 12 of H-ras (coding for valine instead of glycine) in six of the lesions.
CONCLUSIONS
Our data suggest an involvement of the ras gene mutation in conjunction with other yet unknown events in the tumorigenesis and/or progression of malignant fibrous histiocytomas. The K-ras gene activation predominated in these tumors by a mutation at codon 13. It is noteworthy that H-ras mutations were detected only in association with the lesions containing K-ras mutated genes, the significance of which remains to be determined.

Complex Conjunctival Choristoma in Linear Nevus Sebaceous Syndrome: A case report.: Jinyoung Yoo, Jae Kyung Koh, Seok Jin Kang, Byung Kee Kim; Korean J Pathol. 2000;34(9):680-684.

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Abstract PDF: Linear nevus sebaceous syndrome is an uncommon neurocutaneous disorder characterized by nevus sebaceus, seizures, and mental retardation, and is often accompanied by ocular anormalies. We recently experienced a case of conjunctival choristoma associated with linear nevus sebaceous syndrome in a 17-month-old boy. The child was the product of a full-term uncomplicated pregnancy and normal delivery with normal karyotype of 46, XY. He was noted at birth to have a conjunctival mass on the right eye and linear nevi over the midline facial region and right temporoparietal scalp. Ophthalmologic examination revealed optic atrophy, peripapillary staphyloma, macular hypogenesis, and osseous choristoma of the choroid. A computed tomography scan demonstrated widening of the subarachnoid space and moderate atrophy of the cerebral and cerebellar hemispheres. He has been followed by ophthalmology and completely free of seizures since birth. The patient underwent excision of the conjunctival mass and biopsies of the skin lesion at 17 months of age. Histologic examination of the skin biopsies was characteristic for the linear sebaceous nevus of Jadassohn. Histologic findings of the conjunctival lesion showed a complex choristoma that contained lacrimal gland tissue and cartilage.

Telomerase Activity and Expression of Telomerase RNA in Malignant Fibrous Histiocytoma.: Jinyoung Yoo, Seok Jin Kang, Bung Kee Kim; Korean J Pathol. 2000;34(8):581-587.

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Abstract PDF: Telomerase is an RNA-dependent DNA polymerase that synthesizes TTAGGG telomeric DNA onto chromosomal ends to compensate for sequence loss during replication. It has been detected in a variety of human malignancies, suggesting that such activity may play a role in the tumorigenic process. To determine whether telomerase is reactivated in malignant fibrous histiocytoma, 12 tissue samples with this tumor were analyzed for the telomerase activity by a radioactive PCR-based TRAP (telomeric repeat amplification protocol) assay. All of the tumors were further investigated for the expression of human telomerase RNA (hTR) by an in situ hybridization (ISH). Telomerase activity was detected in one (8.3%) sample. Expression of hTR was demonstrated in 7 (58.3%): one telomerase-positive and six telomerase-negatives. These data indicate that the reactivation of telomerase is an uncommon event and not an important factor involved in tumorigenesis in malignant fibrous histiocytoma. It is noteworthy that 50% of the patients with grade 2 tumors expressed hTR, suggesting that telomerase RNA may be useful as a marker for identifying tumor aggressiveness earlier than the conventional histopathologic grading scale.

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