Journal of Pathology and Translational Medicine

Jong Im Lee

14 Articles

Foreign Body Reaction and Expression of Matrix Metalloproteinases/Tissue Inhibitor of Metalloproteinase by Injection of Mineral Fibers in Rats.: Dong Kweon Seo, Jong Im Lee, Jung Ran Kim; Korean J Pathol. 2011;45(6):604-611.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.6.604

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Abstract PDF: BACKGROUND
The host response to natural fibers results in granuloma formation in an effort to limit tissue destruction. Matrix metalloproteinases (MMPs) are important molecules in the inflammatory granulomatous or reparative reaction. Here, we studied the foreign body reaction that occurs following natural fibers implantation by investigating MMPs and tissue Inhibitor of MMPs (TIMPs) in an in vivo model.
METHODS
Female Sprague-Dawley rats were treated with crocidolite fiber or fibrous talc via subcutaneous and intraperitoneal injections and immunohistochemistry was conducted to confirm the expression of MMPs and TIMP-2 in tissue sections.
RESULTS
We identified that mineral fibers elicited granulomas. Fibrous talc or intraperitoneal injection resulted in larger granulomas and severe tissue destruction compared with the lesions induced by crocidolite or subcutaneous injection. The expression of MMPs was elevated while granulomatous lesions were formed. The relative levels of MMPs were lower in the talc injected or intraperitoneal route models than those of crocidolite injected or subcutaneous injection models during the entire experiment.
CONCLUSIONS
These findings demonstrate that specific expression of MMPs/TIMP is inversely related to the grade of tissue destruction and suggest that expression of MMPs is required for promoting granuloma formation and limiting tissue destruction.

Spontaneous Pneumothorax as an Initial Manifestation of Metastatic Papillary Thyroid Carcinoma.: Jong Im Lee, Jung Ran Kim, Soo Sung Kim; Korean J Pathol. 2009;43(1):83-87.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.1.83

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Abstract PDF: Spontaneous pneumothorax occurs in a variety of lung diseases. Primary or metastatic lung cancers are rare, but important causes of pneumothorax. We report here on a case of pulmonary metastasis of thyroid papillary carcinoma that initially presented as spontaneous pneumothorax. A 32-year-old male with no history of thyroid disease underwent wedge resection of the lung due to recurrent pneumothorax. Histologically, the pleura and subpleural lung parenchyma revealed several micronodular lesions and randomly scattered glandular structures with mild cytological atypia. The cells were characterized by their overlapped hypochromatic nuclei with longitudinal grooves and inconspicuous nucleoli. On the additional sections, we found a few intranuclear inclusions and colloid-like material in the follicular structures. The glandular cells were immunoreactive for thyroglobulin, TTF-1, CK 7 and HMW-CK and they were focally immunoreactive for EMA, but they were negative for S100, chromogranin and CEA. The Ki-67 labelling index was 4%. Neck ultrasonography revealed an ill-defined hypoechoic nodule in the left lobe of the thyroid. The diagnosis of conventional, classical papillary carcinoma was made by both the cytology and the total thyroidectomy specimen. Pathologists should conduct a through histologic examination for the patients with recurrent spontaneous pneumothorax to search for the underlying causes.

Oncocytic Type Intraductal Papillary Mucinous Neoplasm Mimicking Mucinous Cystic Neoplasm of the Pancreas: A Case Report.: Tae Jung Jang, Jong Im Lee; Korean J Pathol. 2008;42(3):172-174.

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Abstract PDF: Oncocytic type intraductal papillary mucinous neoplasm is a newly defined subgroup of intraductal papillary mucinous neoplasms. A 35-year-old woman presented complaining of epigastric pain for one month. Enhanced computed tomography revealed a multilocular cystic mass in the distal body and tail of the pancreas. Endoscopic retrograde cholangiopancreatography showed no communication between the mass and the main pancreatic duct. The patient underwent a distal pancreatectomy and splenectomy. Microscopical examination showed a fibrous cyst wall; polypoid tumors exhibiting thin stalks, with extensive arborizing papillary growths from these stalks; and a focally cribriform pattern, lined by plump cells with abundant eosinophilic and granular cytoplasm. Red granules were detected in the cytoplasm of tumor cells on modified Gomori trichrome stain. Ultrastructurally, the tumor cells contained abundant cytoplasm packed with numerous mitochondria and intracellular and intercellular lumina. We describe an oncocytic type intraductal papillary mucinous neoplasm having the clinical characteristics of a mucinous cystic neoplasm.

Touch Imprint Cytology of Adenomatoid Tumor of the Tunica Albuginea: A Case Report.: Jong Im Lee; Korean J Cytopathol. 2008;19(1):47-51.; DOI: https://doi.org/10.3338/kjc.2008.19.1.47

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Abstract PDF

Adenomatoid tumor is a benign neoplasm of a mesothelial origin, and it usually occurs in the reproductive organs, especially in the epididymis. The author experienced a case of adenomatoid tumor involving the tunica albuginea and testicular parenchyme without any evidence of epididymis involvement. The patient was a 36-year-old man with a painless scrotal mass that he had experienced for 2 months, and this mimicked testicular neoplasia, including metastatic carcinoma, or other benign lesions. The imprint cytology of the tumor showed a hypocellular smear with mainly arranged cells in cohesive monolayered clusters along with occasional singly dispersed cells and naked nuclei in a clean background. The cellular clusters formed vague glandular and cord-like structures. The tumor cells were large polygonal to columnar cells with a relatively monomorphic appearance. The nuclei were oval to round shape and they showed vesicular, fine chromatin and inconspicuous nucleoli. The cytoplasm was moderate to abundant, and it contained fine vacuoles in some tumor cells. Mitoses and cellular pleomorphism were not present. Awareness of the cytologic finding of this lesion is necessary to screen or differentiate a testicular or paratesticular mass before and/or during surgery because the cytology may be useful as a diagnostic tool. Pathologists should be aware of the cytologic features of common lesions in this anatomic region so as to avoid performing aggressive and unnecessary surgical procedures.

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Adenomatoid Tumor of the Tunica Albuginea in a Boy: A Case Report and Literature Review
Kaimin Guo, Runhui Tian, Lingyun Liu, Congqi Du, Fubiao Li, Hongliang Wang
Case Reports in Urology.2015; 2015: 1. CrossRef
Aspiration cytology of adenomatoid tumor of epididymis: An important diagnostic tool
S. Gupta, S. Garg, R. Agarwal, R. Sen
Journal of Surgical Case Reports.2012; 2012(4): 11. CrossRef

Touch Imprint and Fine Needle Aspiration Cytology of Giant Cell Tumor of Tendon Sheath: A Case Report.: Jong Im Lee; Korean J Cytopathol. 2008;19(1):57-64.; DOI: https://doi.org/10.3338/kjc.2008.19.1.57

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Abstract PDF: Giant cell tumor of the tendon sheath (GCTTS) is a slowly growing, benign soft tissue tumor. The tumors occur predominantly on the hands and feet. Although the clinical and histopathologic features are well-defined, only a few reports have described the cytologic appearance of this entity. A 26-year-old woman presented with a gradually developing circumscribed soft tissue mass near the proximal phalanx of her left little finger for one year. Imprint and fine needle aspiration (FNA) smears were obtained from the excisional biopsy specimen. The imprint smears were composed of predominantly singly dispersed bland mononuclear cells and several giant cells. The mononuclear cells were polygonal to round, and they showed a histiocyte-like appearance. Osteoclast-type multinucleated giant cells of various sizes were randomly scattered throughout the smears, and these cells contained 3 to 50 nuclei. Nuclear atypia and pleomorphism were absent in both the single and giant cells. Loose aggregates of hemosiderin-laden macrophages and binuclear stromal cells were also seen. The cytologic features of the FNA smears were similar with those of the imprint. Additionally, the FNA smears contained several clumps of densely collagenous stromal tissue that were seldom noted in previously reported cytologic material. The cytologic features were well-correlated with the concurrent histologic findings and the diagnosis of GCTTS was made. When the clinical and radiologic datas are integrated, the diagnosis of GCTTS can be strongly suggested, based on the pre-operative cytologic specimen.

Silica Granuloma after Intermittent Intramuscular Injections: A Case Report.: Suk Jin Choi, Jong Im Lee, Jung Ran Kim, Tae Jung Jang, Ki Kwon Kim, Phil Hyun Chung; Korean J Pathol. 2003;37(5):369-372.

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Abstract PDF: Most silica-contaminated wounds of the skin heal without complications. Cutaneous silica granuloma is a poorly understood, uncommon condition resembling a sarcoidosis. We report a case of silica granuloma after intermittent intramuscular injections. A 70-year-old man presented a painless mass in his right buttock for 2 weeks. He had received intermittent intramuscular injections of antihistamine drugs due to chronic dermatitis for 30 years. The histolopathological findings showed numerous hyalinized collagenous nodules with concentric layers, and an ill-defined chronic granulomatous inflammation containing foreign material. A polarized light microscopic examination revealed birefrigent particles. The presence of silica components was confirmed by scanning electron microscopy and energy dispersive X-ray microanalysis.

Significance of CD99 Immunoreactive Cells in relation to Gastrin-producing Cells in Human Gastric Mucosa.: Eun Young Kim, Jong Im Lee, Jung Ran Kim; Korean J Pathol. 2003;37(4):263-269.

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Abstract PDF: BACKGROUND
CD99 is characteristically expressed in Ewing's sarcoma/primitive neuroendocrine tumors and its immunoreactivity has also been reported in gastrointestinal neuroendocrine tumors. However, the normal distribution of CD99 reactive cells in gastrointestinal mucosa and their function are not fully understood.
METHODS
We performed an immunohistochemical study using antibodies to CD99 and gastrin on formalin fixed and paraffin embedded tissue of the stomach.
RESULTS
CD99 were strongly expressed in the gastric glands of neonate (3/3) and infant (1/1) cases but not detected in the fetal period (0/30). In adults, CD99 was observed in 36.8% (7/19). The number of CD99 positive cells were fewer in adult (3.48+/-6.43) than in neonate (5.66+/-0.58) and infant (11.33+/-2.21). CD99 was mostly located along the cytoplasmic membrane of glandular cells but cytoplasmic expression was also evident in neonate and infant cases. The G cells and CD99 expressed cells were reduced in the area showing intestinal metaplasia and atrophic change. As a result of the double stain, some of the G cells coexpress CD99 antigen, which were more in neonate (29%) than in adult (2.6%).
CONCLUSIONS
The CD99 positive cells were found in the gastric pyloric antrum during the postnatal period and progressively reduced with age. This suggests the participation of CD99 protein in the differentiation and secretory process of neuroendocrine cells.

Histopathologic Change and Apoptotic Profile in Basal Ganglia of Rat Induced by Manganese Administration.: Chang Won Ha, Jong Im Lee, Jung Ran Kim, Tae Jung Jang, Ki Kwon Kim, Dong Hoon Kim; Korean J Pathol. 2000;34(6):419-430.

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Abstract PDF: Mn (manganese) is known to induce Parkinsonian neurological disorder. Several lines of evidence suggest that apoptosis is involved not only in physiological cell death during normal development but also in neurodegenerative disease. The mechanism of Mn induced cell death remains poorly understood. In the present study, we evaluated the morphologic changes and apoptotic profile in basal ganglia using rat model of Mn toxicity. The rats were divided into three groups: the first group was a control; the second group was subdivided by administration dosage of Mn into group A (5, 10 mg MnC12/ kg) and group B (20, 40 mg MnC12/kg). The rats of each subgroup received a injection of Mn via tail vein every week for 4 weeks. The second group received 4 repeated injection of 10 mg MnC12/kg in the same manner and the rats were sacrificed at day 1, 3 & 7 in group I and at day 10, 21, 42, and 90 in group II after the last injection. A significant loss of neuron and gliosis were observed in the basal ganglia in the experimental groups (p<0.05), which were more pronounced in group II than in the control or group I. No significant difference in number of nerve cells or degree of gliosis was identified in the substantia nigra. Apoptotic cells were also increased in basal ganglia of experimental groups and appeared among neurons (10%), glial cells (10%), and endothelial cells (60%). Apoptotic figures were consistently noted through the entire experimental period after Mn injection in basal ganglia. In conclusion, these results demonstrate that Mn-induced cytopathic insult affects various cell types in basal ganglia and shows variable sensitivity in the different regions of brain, especially in the apoptotic cell death of the neuron. The overaccumulation of Mn in the brain might be attributed from the breakdown of blood-brain barrier due to the injury through the apoptosis.

Manganese Intoxication in the Rat A neuropathologic study and distribution of manganese in rat brain.: Tae Jung Jang, Jung Ran Kim, Jong Im Lee, Dong Hoon Kim, Ki Kwon Kim, Ji Yong Kim, Hae Kwan Cheong, Hyun Sul Lim; Korean J Pathol. 1999;33(9):662-674.

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Abstract PDF: We investigated a topographical distribution of managanese, and immunohistochemical density of tyrosine hydroxylase (TH), and histopathologic findings in globus pallidus and substantia nigra according to manganese dose and time course in the brain of rats which received MnCl2 intravenously. Topographical distribution of manganese was also investigated after injection of FeCl2. The manganese concentrations of brain in control and experimental group were highest in pituitary gland and thalamus, and lowest in the cerebral cortex. The manganese concentration of blood was increased proportionally to the dose administered, and the biological half-life of blood manganese was between 21 and 42 days. The manganese concentrations of brain were increased proportionally to the dose, and increase rate was highest in olfactory bulb, and the biological half-lives of brain manganese ranged from 42 days to 90 or more days; the longest were observed in pituitary gland, medulla oblongata and cerebral cortex. In case of administration of FeCl2, the manganese concentrations of brain were higher than that of control group in dose of 2.5 mg/kg, and decreased proportionally to the administered dose, resulting in lower level compared with control group in high dose of FeCl2 administered. Significantly decreased number of nerve cell and increased gliosis in globus pallidus were observed in experimental group, which were closely correlated with the duration after manganese injection, but no significant change of number of nerve cell expressing TH and gliosis were observed in substantia nigra. Density of immunohistochemical reaction for TH in globus pallidus made little difference between control and experimental group. These results suggest that pathology of manganese intoxication is caused by the loss of nerve cells in globus pallidus, and closely correlated with the duration after manganese exposure.

Imprint Cytologic Features of Fibroadenoma of the Breast with Extensive Infarction: A Case Report .: Suk Jin Choi, Jong Im Lee, Jung Ran Kim, Tae Jung Jang, Ki Kwon Kim, Dong Hoon Kim, Byoung Ook Jeoung; Korean J Cytopathol. 1999;10(2):169-174.

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Abstract PDF: Spontaneous Infarction of fibroadenoma of the breast is very uncommon and may lead to difficulties in clinical and pathological diagnosis. Most reported cases occured in young women during pregnancy or lactation. This report describes imprint cytologic features of an infarcted fibroadenoma in a 19-year-old young woman without evidence of pregnancy. The smears revealed many individually scattered degenerated or necrotic epithelial or spindle stromal cells and naked nuclei on dirty necrotic background. A few sheets of cohesive uniform epithelial cells and a few fragments of stromal cells were also present. Most of the epithelial cells had pyknotic and hyperchromatic nuclei, however, cellular atypism such as pleomorphism, prominent nucleoli or mitosis were not present. Though the necrotic ductular and glandular outline of this case may bear a superficial resemblance to adenocarcinoma, obvious cytologic atypia or mitosis, even in the necrotic areas, were not present.

Expression of TGF-beta1 Protein in Macrophages of Tuberculous Granulomas.: Jong Im Lee, Jung Ran Kim, Tae Jung Jang, Dong Hoon Kim; Korean J Pathol. 1998;32(4):261-265.

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Abstract PDF: TGF-beta1 expression was studied in 25 patients with tuberculosis (lung, 9 cases and lymph node, 16 cases) using a polyclonal antibody in formalin-fixed paraffin embedded tissue. Nineteen cases (76.0%) out of 25 cases showed TGF-beta1 expression. TGF-beta1 was present in cytoplasm of epithelioid cells and Langhans' giant cells. Pulmonary tuberculosis and tuberculous lymphadenitis showed different patterns of staining. Five of 9 cases of pulmonary tuberculosis were positive for TGF-beta1: four of acid-fast bacilli positive cases (4/5, 80.0%) and one of acid-fast bacilli negative cases (1/4, 25.0%). However, high expression of TGF-beta1 was detected in tuberculous lymphadenitis of both acid-fast bacilli positive group (3/4, 75.0%) and acid-fast bacilli negative group (11/12, 91.7%). TGF-beta1 was also expressed in all of 6 cases of BCG-induced tuberculous lymphadenitis: 2 acid-fast bacilli positive and 4 acid-fast bacilli negative cases. TGF-beta1 expression was shown in 19 cases (86.4%) of 22 in active tuberculosis, while no TGF-beta1 expression was detected in any cases of inactive, healed tuberculosis (p<0.008). This study supports that the TGF-beta1 expression of epithelioid cells may alter their function resulting in the impaired antimycobacterial activity. Thus the increased production of TGF-beta1 may be one of the important mechanisms by which Mycobacterium tuberculosis avoids destruction by host macrophages.

Granulomatous Inflammation of Hand following Sea Urchin Sting: 2 cases report.: Jung Ran Kim, Dong Hoon Kim, Tae Jung Jang, Jong Im Lee, Hyun Sul Lim, Hyeon Kyeong Lee, Sung Han Bae; Korean J Pathol. 1998;32(1):68-71.

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Abstract PDF: Injuries from sea urchins are induced by from penetration of the calcareous spines into the skin. Apart from the transient episode of excruciating pain, there is usually no residual disability. Complications arise, however, when spines are embedded over bony prominences, or within joints. Two cases are reported with injury and protracted disability of fingers resulting from contact with the purple sea urchin, Anthocidaris crassispina, a common echinoderm inhabitant of the Korean east coast. After a latent period of several months in both cases, Case 1 presented as caseating granulomas in the synovium and case 2 exhibited as the usual soft tissue nonsynovial foreign body and noncaseating granulomas. There appears to be a paucity of published data regarding the effects of puncture wounds caused by the spines of this animal. The granulomas have appeared after a latent interval of several months in a proportion of the sufferers, suggests a delayed hyperserisitivity reaction similar to that produced by Mycobacterium species.

Detection of Helicobacter pylori in Gastric and Duodenal Biopsy Specimens by Immunohistochemical Stain.: Jong Im Lee, Jung Ran Kim, Jung Ho Lee, Gyoung Yim Ha; Korean J Pathol. 1996;30(10):873-885.

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Abstract PDF: A large body of evidence indicates that Helicobacter pylori is involved in the pathogenesis of chronic gastritis and peptic ulcers. Several techniques are currently used for detecting H. pylori. Recently the immunohistochemical method was introduced for rapid detection of H. pylori. To compare the result of the immunohistochemical method with those obtained by microbiologic methods, we glean formalin fixed, paraffin embbeded gastric and duodenal biopsy specimens from 85 patients with upper gastrointestinal symptoms. We set fifty cases which H. pylori was cultivated and identified by Gram stain as Group I, and thirty-five cases without H. pylori in Gram stain and culture as Group II. The results were as follows. 1) The sensitivity and the specificity of immunohistochemical method were 94% and 80% compared with the microbiologic method. Positive and negative predictive value of the immunohistochemical method were respectively 87% and 90%. However, in seven cases of Group II, H. pylori were identified by immunohistichemical method. 2) Immunohistochemical staining exhibited bacteria that were present in the mucus layer, the surface of the gastric mucosa and metaplastic gastric epithelium in duodenum. With reference to the distribution and density of H. pylori in Group I and II, a significant correlation existed between microbiologic results and bacterial load of the biopsy specimen (p<0.01). 3) Chronic inflammation of gastric biopsies were seen in all 45 H. pylori-positive cases(100%) and 16 out of 19 H. pylori-negative cases(84%). The degree of chronic inflammation was more severe in positive cases than negative cases. Activity of inflammation was seen 98% of H. pylori-positive cases and 16% of H. pylori-negative cases. Intestinal metaplasia was seen 40% of H. pylori-positive cases and 58% of H. pylori-negative cases. Lymphoid follicles and aggregates were seen in 47%(27 cases) of H. pylori-positive cases. Among 47%, cases with lymphoid follicles were 9%(4 cases) and cases with lymphoid aggregates were 38%(17 cases). In H. pylori-negative cases, lymphoid follicles and aggregates were seen in 16%(3 cases). It is possible to obtain samples from most of the individuals who underwent the endoscopy in Korea. And this method is simple, rapid and sensitive. We conclude that the immunohistochemical method is another useful diagnostic tool for detection of Helicobacter pylori.

A Case of Intestinal Anthrax with Recovery after Surgical Intervention .: Jong Im Lee, Jung Ran Kim, Dong Hoon Kim, Byoung Ook Jeoung; Korean J Pathol. 1995;29(2):268-271.

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Abstract PDF: Anthrax in man is usually cutaneous, resulting from contact with materials derived from infected livestock. Internal organs are infrequently involved,. This report concerns a case of primary anthrax of intestine. The first case of primary anthrax of intestine is to our knowledge in Korea. The patient was a 14-year-old male who has complained of nausea, vomiting and acute abdominal pain. History was otherwise noncontributory except for ingestion raw meat of the dead cattle, one day before the onset of the disease. The cattle presumably died due to Bacillus anthracis in a village Bae-Ban Dong in the city of Kyung ju, Kyung Pook. Among 15 sufferers, 2 cases died 3 days later. Bacillus anthracis isolated from the raw beef, blood samples of two patients and throat culture of one patient. At laparotomy, the peritoneal cavity was full of serosanginous fluid. Right hemicolectomy including partial resection of ileum was done. The bowel was segmentally dilated, hemorrhagic and necrotic, especially at terminal ileum. The mucosa was edematous and largely ulcerated covered with greenish yellow exudate. The intense vascular congestion with hemorrhage and numerous colonization of bacteria were present through the entire wall. The organisms were large, gram-positive and PAS-negative bacilli in long chain. Bacterial emboli were scattered in lymphatics. The other feature was band like lymphoid cell infiltration in ulcer base and submucosal layer. Payer's patches were prominent and the germinal centers were necrotic. Interfollicular spaces exhibited aggregates of numerous atypical lymphoid cells. The cells were five times larger than resting lymphocytes and had several prominent nucleoli and abundant amphophilic cytoplasm. On immunohistochemical staining, most of atypical cells were positive for T-cell marker and Ki-I Ag. The mesenteric lymph nodes were enlarged, showing reactive feature, and the atypical cells were also demonstrated. The patient recovered completely.

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