- Subcutaneous Neuromuscular Hamartoma: A case report.
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Dong Hoon Kim, Eun Kyung Hong, Jung Dal Lee
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Korean J Pathol. 1999;33(1):62-64.
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- Subcutaneous form of neuromuscular hamartoma is extremely rare and histologically different from the conventional neuromuscular hamartoma of the peripheral nerve or benign Triton tumor by an indistinct nodular growth with ill-defined margin and marked collagen interposition. It is usually not associated with a major nerve. We report a case of subcutaneous neuromuscular hamartoma developed in the forehead of 24-year-old man. The tumor showed proliferation of dense, hyalinized fibrous tissue, in which single or group of mature skeletal muscle fibers and nerve fibers were haphazardly intermixed. Recognition of abnormally arranged muscle and nerve fibers is important not to miss this lesion.
- Primary Hepatic Leiomyosarcoma.
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Won Mi Lee, Chan Kum Park, Eun Kyung Hong, Moon Hyang Park, Jung Dal Lee
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Korean J Pathol. 1998;32(12):1092-1094.
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- Primary hepatic sarcoma is a rare tumor, with fewer than 60 previously reported cases. It is thought to arise from hepatic connective tissue or vascular channels. The tumor is located usually in the intrahepatic area. Pedunculated or bulging lesion is also reported. We report a case of primary leiomyosarcoma of the liver occuring in a 62-year-old Korean woman. A pedunculated, 21 16 cm sized mass is located in the left lateral segment of the liver. Microscopically, the tumor is hypercellular and composed of elongated, partly pleomorphic spindle cells with blunt-ended nuclei, which are focally reactive for muscle specific actin. Mitotic figures are 5/10 high power fields (HPFs). No other primary site is recognized on clinical study.
- Prognostic Significance of the Tall Cell Variant of Papillary Thyroid Carcinoma: Expression of p53, bcl-2 & Leu-M1 proteins.
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Won Mi Lee, Joo Seob Keum, Eun Kyung Hong, Moon Hyang Park, Jung Dal Lee
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Korean J Pathol. 1998;32(11):1000-1007.
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- Papillary carcinoma of the thyroid is a well differentiated neoplasm and usually has a good prognosis. However, a subset of morphologically distinct papillary carcinoma has bad prognoses. The tall cell variant of papillary carcinoma (TCPC), characterized by tall columnar cells with a height at least twice the width, is the one of these. In order to differentiate TCPC from usual papillary carcinoma (UPC) in terms of prognosis, we performed immunohistochemical studies for the expression of p53, bcl-2 and Leu-M1 proteins in 25 cases of TCPC, 26 cases of UPC and 14 cases of poorly differentiated, solid type papillary carcinoma (SPC) with an analysis of clinical parameters. The nuclear expression of p53 was noted in one case each of UPC and TCPC. The cytoplasmic p53 expression of TCPC, UPC, and SPC was observed in 17/25 cases (68%), 14/26 cases (54%), 3/14 cases (21%), respectively. bcl-2 expression was 19/25 cases (76%), 18/26 cases (69%), 5/14 cases (36%), and that of Leu-M1 was 21/25 cases (84%), 18/26 cases (69%), 4/14 cases(29%), respectively. There were no statistical significance in the expression of those immunoproteins among these three groups (p>0.05). The p53 protein was consistently expressed in the cytoplasm rather than nucleus in this study and was very well correlated to bcl-2 positivity (p<0.01). There were no statistical significance in any clinical parameters examined among these three groups (p>0.05). In conclusion, TCPC can not be separated from UPC as a distinct entity in this study and the cytoplasmic expression of p53 protein provides another mechanism of p53 inactivation in tumorigenesis of the thyroid papillary carcinoma, possibly by bcl-2 related mechanism.
- Prognostic Significance of PCNA Index and AgNORs Score in Transitional Cell Carcinoma of the Renal Pelvis.
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Wan Seop Kim, Seung Sam Paik, Nam Hoon Kim, Moon Hyang Park, Jung Dal Lee
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Korean J Pathol. 1998;32(7):521-530.
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- Proliferative activity of a malignant tumor is known to reflect its biological aggressiveness. Proliferating cell nuclear antigen (PCNA) is a marker of cellular proliferation, and silver-stained nucleolar organizer regions (AgNORs) have been shown to correlate with ploidy and proliferative activity of cells. In transitional cell carcinoma of the renal pelvis, the prognostic value of these markers has not been well defined. We studied PCNA expression and the AgNORs count in 22 transitional cell carcinoma of the renal pelvis to assess their prognostic significance compared with their cumulative survival rate, the stage of disease and histopathologic features of the tumors. An immunohistochemical method and a standard colloidal silver staining were used. The mean percentage of PCNA positivity (PCNA index) and the mean number of AgNORs per nucleus (AgNORs score) were determined. In a multivariable analysis, PCNA indexes were significantly associated with tumor stage (p=0.024), whereas AgNORs scores were not significantly associated with the stage or histopatholgic features of the tumors. Histologic grade was correlated to disease stage at a significant level (p=0.000). But there was a trend of low tumor PCNA-indices or AgNORs counts with survival advantage for patients, but this did not reach statistical significance. The results suggest that the fraction of PCNA positive nuclei would be useful for investigating the malignant potential of renal pelvic cancers, although their clinical use as markers of biologic behavior may be limited.
- Extrapulmonary Silicosis: A case report.
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Won Mi Lee, Se Jin Jang, Eun Kyung Hong, Jung Dal Lee
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Korean J Pathol. 1998;32(7):540-542.
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- A case of extrapulmonary silicosis involving abdominal lymph nodes in a 62-year-old man is presented. The patient underwent subtotal gastrectomy and regional lymph nodes dissection for gastric adenocarcinoma of clinical stage III.
On gross examination, two separate gastric adenocarcinomas and multiple enlarged lymph nodes mimicking metastatic lesion were noted. Microscopic examination of the enlaged lymph nodes revealed characteristic sclerohyaline silicotic nodules without metastatic adenocarcinoma. Chest roentgenogram showed diffusely scattered multiple tiny nodular lesions in the entire lung fields, particularly the posterior side of both upper lung fields. He had worked in a mine for 18 years and had been exposed to silica for 5 of those years. We report incidentally found, unusual case of extrapulmonary silicosis.
- Carcinosarcoma of the Female Genital Tract: Immunohistochemical study on transitional area further supports the metaplastic origin.
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Chan Pil Park, Joo Seob Keum, Gu Kong, Moon Hyang Park, Jung Dal Lee
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Korean J Pathol. 1998;32(5):370-377.
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- Carcinosarcoma of the female genital tract, also called malignant mixed mullerian tumor (MMMT), is a rare and relatively aggressive tumor with various homologous and heterologous components. There have been various studies to find prognostic factors and to investigate the histogenesis, including tissue culture, electron microscopy, and immunohistochemical studies. We investigated carcinomatous, sarcomatous, and transitional areas of 6 cases of carcinosarcoma of the uterus and ovary by using epithelial and mesenchymal markers. Immunohistochemical profiles of the transitional areas were significantly different from those of carcinomatous and sarcomatous areas. Immunoreactivities for cytokeratin and epithelial membrane antigen (50% and 22.2%) were weaker than those of carcinomatous areas (95.2% and 100%), but stronger than those of sarcomatous areas (11.1% and 5.6%)(p<0.01). In transitional areas, vimentin, smooth muscle actin and S-100 protein were more strongly expressed than in carcinomatous areas, but more weakly expressed than in sarcomatous areas (p<0.01, p<0.01, and p=0.018, respectively). Myoglobin was entirely negative in carcinomatous areas and immunoreactive in minor portions of transitional and sarcomatous areas (22.2% and 16.7%, respectively). These results suggest that the transitional areas are between the carcinomatous and sarcomatous nature in differentiation, further supporting that the carcinosarcomas of the female genital tract may arise, through metaplastic change, from a type of carcinoma.
- Intraductal Variant of Peripheral Cholangiocarcinoma of the Liver A report of three cases.
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Won Mi Lee, Seok Hoon Jeon, Eun Kyung Hong, Moon Hyang Park, Jung Dal Lee
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Korean J Pathol. 1998;32(3):222-225.
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- Intraductal variant of peripheral cholangiocarcinoma is extremely rare. This variant shows intraductal growth and intraluminal extension without any infiltrative growth. The mode of intraductal growth is not known. The prognosis of this variant is better than that of usual cholangiocarcinoma. We report three cases, one of which is associated with Clonorchis sinensis (CS) infection. The tumors were entirely confined within the dilated peripheral tributaries of the intrahepatic bile duct. Microscopically, the tumors were well to moderately well differentiated, with a papillary or a micropapillary growth pattern. Focal clear cytoplasmic change and mucin production were noted. The tumors showed intraductal spreading without any invasion to the liver parenchyme. Mucosal hyperplasia and dysplasia were noted in the adjacent ducts. The authors assume that intraductal cholangiocarcinoma is a distinct subtype, and persistent irritation, such as, CS infection may undergo a malignant transformation through mucosal dysplasia.
- Granular Cell Tumor of the Thyroid.
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Haeng Ji Kang, Eun Kyung Hong, Moon Hyang Park, Jung Dal Lee
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Korean J Pathol. 1998;32(1):63-67.
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- Granular cell tumor is not uncommon and is a well recognized entity which may arise at virtually any site of the body.
However, occurrence in the thyroid is extremely rare and has not been described well. Only three cases could be found in the English literatures. We report a case of granular cell tumor of the thyroid in a 30 year-old woman. The tumor was illdefined, infiltrative and was composed of diffuse sheets of polygonal to fusiform cells with abundant eosinophilic granular cytoplasm. The tumor showed evidence of Schwann cell differentiation in immunohistochemical and ultrastructural examinations. Differentiation from more common thyroid tumors having oncocytic granular cytoplasm should be made by immunohistochemistry or electron microscopy.
- Cytopathologic Analysis on Fine Needle Aspiration Cytologic Misdiagnoses of the Thyroid .
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Chan Pil Park, Joo Seob Keum, Won Mi Lee, Moon Hyang Park, Jung Dal Lee
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Korean J Cytopathol. 1998;9(2):169-180.
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- Fine needle aspiration cytology(FNAC) has been used effectively as the initial modality in evaluating various thyroid lesions. We correlated cytologic and histopathologic features to investigate the diagnostic pitfalls of FNAC of the thyroid.
A total of 1,593 FNACs of the thyroid were diagnosed at the Department of Pathology, Hanyang University Hospital, from January 1993 to December 1997. There were 963 cytologically benign cases(60.5%), 97 suspicious cases(6.1%), and 75 malignant cases(4.71%). The remaining 458 cases(28.8%) were unsatisfactory. Subsequent surgical resection was done in 192 cases. Seventy-two cases(37.5%) were cytologi cally diagnosed as benign, 45 cases(23.4%) suspicious, 56 cases(29.2%) malignant, and 19 cases(9.9%) unsatisfactory. Histopathologically, 101 cases were benign(11 thyroidites, 52 adenomatous hyperplasias, 34 follicular adenomas, and four Hurthle cell adenomas), and 91 cases malignant(72 papillary carcinomas, 16 follicular carcinomas, one medullary carcinoma, one anaplastic carcinoma, and one granular cell tumor). After excluding 19 unsatisfactory cases, 63 were misdiagnosed. They included 17 benign(three thyroidites and 14 adenomatous hyperplasias), 27 suspi cious(16 follicular adenomas, four Hurthle cell adenomas, and seven follicular carcinomas), and 19 malignant(16 papillary carcinoma, one medullary carcinoma, one anaplastic carcinoma, and one granular cell tumor) lesions.
The accuracy rates in the benign, suspicious, and malignant categories were 54.9%, 49.8%, & 92.8%, respectively. The cytological pitfalls were as follows: (1) bloody background, (2) crowded follicular cell clusters indistinguishable between follicular neoplasia and adenomatous hyperplasia, (3) papillary structure, irregular nuclear membrane and pleomorphism mimicking those of papillary carcinoma, (4) indistinct eosinophilia in follicular epithelial cells, (5) unusual cellular components not commonly seen in FNACs of the thyroid.
- Fine Needle Aspiraton Cytology of Polymorphous Low Grade Adenocarcinoma in the Hard Palate: A Case Report .
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Wan Seop Kim, Seok Hoon Jeon, Eun Kyung Hong, Moon Hyang Park, Jung Dal Lee
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Korean J Cytopathol. 1998;9(2):181-186.
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- Polymorphous low grade adenocarcinoma(PLGA) is a rare malignant tumor of the salivary gland. It is characterized by diverse histology, bland-looking cytology, indolent behavior and favorable prognosis. The fine needle aspiration cytologic features of PLGA are described. The aspirates from the hard palate in a 33-year-old woman showed cellular smear composed of monotonous small round to oval cells with scanty cytoplasm. Papillary, tubular and cell ball arrangements with characteristic dense stromal spheres were recognized. PLGA could be suggested by fine needle aspiration cytology, if one encountered cellular smear with various architectures and uniform bland-looking cytologic feature.
- Fine Needle Aspiration Cytology of Glycogen-Rich Clear Cell Carcinoma of the Breast: A Report of Two Cases .
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Wan Seop Kim, Won Mi Lee, Eun Kyung Hong, Moon Hyang Park, Jung Dal Lee
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Korean J Cytopathol. 1998;9(2):213-219.
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- Glycogen-rich clear cell carcinoma of the breast is an unusual variant of carcinoma with a recorded incidence of 1.4-3% of breast carcinomas. The cytologic characteristics have not been well described. We report two cases of glycogen-rich clear cell carcinoma with corresponding fine needle aspiration(FNA) cytologic findings and compare them to infiltrating ductal carcinoma and other clear cell malignancies with a review of literature. One was a 62-year-old woman exhibiting a palpable mass of the right breast. The smears showed atypical tight cell clusters and individually scattered single cells containing foamy or clear abundant cytoplasm with well defined cytoplasmic margins. Mild to moderate nuclear pleomorphism and a prominent nucleolus were present. The other was a 42-year-old woman who was admitted with a right breast mass.
The smears showed moderately cellular, tightly cohesive tumor cells. The cytoplasmic outline was generally well demarcated. The tumor cells contained foamy to clear abundant cytoplasm with large and small vacuoles. The nuclear pleomorphism was marked. Both tumors resected by modified radical mastectomy, were diagnosed as glycogen-rich clear cell carcinoma. Histologically, the clear cell nature of tumor cells were not characteristic enough to predict this type of the tumor. Some cytologic features can be distinguished other clear cell breast cancer from glycogen-rich carcinoma. Recognition of these unusual patterns in a breast FNAC should raise the suspicion of a clear cell carcinoma including glycogen-rich subtype.
Cytological localization of glycogen using PAS and D-PAS staining may permit the correct identification and differential diagnosis of this tumor.
- Composite Adenocarcinoma and Choriocarcinoma of the Sigmoid Colon with Hepatic Metastasis of the Choriocarcinomatous Component.
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Young Ha Oh, Won Mee Lee, Kyung Sook Kim, Moon Hyang Park, Jung Dal Lee
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Korean J Pathol. 1997;31(8):788-793.
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- A rare case of hepatic metastasis with a choriocarcinomatous component from a composite adenocarcinoma and choriocarcinoma of the sigmoid colon in a 60-year-old man is reported. The hepatic metastasis displayed choriocarcinoma with extensive hemorrhagic necrosis. The tumor cells were poorly differentiated with scattered foci of bizzare syncytiotrophoblastic cells. Retrospective examination of the previous colonic carcinoma proved that the tumor was composed of two distinctive elements. One was a moderately well differentiated adenocarcinoma located in mucosa and submucosa. The other was a deep seated and undifferentiated carcinoma which was made up of hyperchromatic bizzare cells with syncytiotrophoblastic cells. There were transitional foci from adenocarcinoma to undifferentiated carcinoma with trophoblastic cells. Immunohistochemical staining showed beta-hCG expression in the undifferentiated cells of both the primary and the metastatic tumors. Implications for the possible origin and cause of tumor cell heterogeneity are briefly discussed.
- Detection of the c-m c Oncogene Amplification in Ovarian Carcinomas by Differential Polymerase Chain Reaction.
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Geun Shin Lyu, Chan Kum Park, Chun Geun Lee, Youl Hee Cho, Youn Yeoung Hwang, Jung Dal Lee
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Korean J Pathol. 1997;31(7):644-654.
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- The amplification of c-myc oncogene was evaluated in 42 cases of ovarian carcinomas to correlate with clinical parameters. Using oligonucleotide primers, sequences from the c-myc exon-3 gene and from a control gene, tissue plasminogen activator (tPA), were amplified simultaneously by polymerase chain reaction (PCR). After the products of differential PCR (d-PCR) were electrophoresed, slot blot hybridization was performed, and hybridized with P32 dATP-labeled myc and tPA oligonucleotide probes and then autoradiographed. The signal intensities of the two products were quantitated by densitometry and the ratios of two products (c-myc/tPA) were measured. The ovarian carcinomas showed significantly increased amplification of c-myc oncogene Oligonucleoti compared to normal control group (p<0.05). 15 of 42 cases (35.7%) showed various degrees of the MYC gene amplification up to 27 folds in various histologic types of ovarian carcinomas. No significant differences of the MYC gene amplification according to histologic subtypes, tumor action) grades and clinical stages of ovarian carcinomas were present.
- Alteration of p53 Tumor Suppressor Gene in Hyperplastic Lesions and Adenocarcinomas of Uterine Endometrium - Immunohistochemistry and PCR-SSCP.
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Eun Kyung Kim, Chan Kum Park, Gu Kong, Moon Hyang Park, Jung Dal Lee
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Korean J Pathol. 1997;31(7):662-671.
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- To investigate the role of the p53 gene in the development of endometrial adenocarcinoma and to study the relation between alteration of the p53 gene and histologic grade, the author studied the alteration of thep53 gene in hyperplastic lesions and adenocarcinomas of the uterine endometrium. The study was carried out with immunohistochemical stain and PCR-SSCP. The materials included ten cases of endometrial hyperplasia (five simple and five atypical complex) and 18 cases of endometrial adenocarcinoma. Overexpression of the p53 protein were found in one of five atypical complex hyperplasias (20%) and 11 of 18 adenocarcinomas (61.1%). The intensity of p53 overexpression appeared to have increasing tendency with higher histologic grade of adenocarcinomas.
Among the II cases of adenocarcinoma that overexpressed p53 protien, five cases (45.5%) were found to have mutations by PCR-SSCP. One was grade 1 (20%), two were grade 11 (25%), and two were grade III (40%). The sites of mutation were three exon 8, one exon 5, and one exon 6. In conclusion, alteration of the p53 gene may paly a role in the development of endometrial adenocarcinoma and appears to occur as a late event in carcinogenesis.HHowever, inactivation of the p53 gene in early stage of tumor development cannot be excluded.
- Congenital Mesoblastic Nephroma.
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Seok Hoon Jeon, Seung Sam Paik, Nam Hoon Kim, Moon Hyang Park, Jung Dal Lee
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Korean J Pathol. 1997;31(4):375-378.
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- Mesoblastic nephroma is an important differential diagnosis of a renal mass occurring in the neonatal period or in early childhood. It is a rare monomorphous congenital renal neoplasm most commonly recognized during the first 3 months of life. With the widespread application of ultrasound imaging, many cases are recognized prior to birth. We report a case of mesoblastic nephroma detected by ultrasonograph at 36 weeks of intrauterine fetal life and removed after birth.
It showed a well circumscribed, grayish white, solid mass measuring 4x3x2 cm. The tumor was predominantly a classic type with a focal cellular pattern. Immunohistochemical and electron microscopic studies were done.
- Carcinosarcoma and Multiple Early Gastric Carcinomas of the Stomach.
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Won Mee Lee, Young Ha Oh, Moon Hyang Park, Kwang Su Lee, Jung Dal Lee
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Korean J Pathol. 1997;31(3):252-256.
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- We report a rare case of carcinosarcoma arising in the stomach. The tumor is presented in the posterior wall of the gastric lower body and antrum of a 56-year-old man. Grossly the tumor has polypoid appearance with diffuse surface ulceration and measures 5.5 cm in diameter. The tumor is accompanied with three separate well differentiated early gastric adenocarcinomas (two EGC type IIc & IIa).
Microscopically, the tumor consists of moderately well differentiated adenocarcinoma in the periphery, and lobulated sarcomatous areas in the center, which shows chondroid differentiation. Transitional areas between adenocarcinoma and chondrosarcoma are evident.
Immunohistochemical studies show positivity for cytokeratin and carcinoembryonic antigen in the epithelial component, and for vimentin and S-100 in the sarcomatous component. The transitional areas are positive in carcinoembryonic antigen, vimentin, S-100, and cytokeratin. The tumor extended to the subserosa and showed metastasis of only adenocarcinomatous component in six out of 47 dissected perigastric lymph nodes.
- Malignant Glomus Tumor Arising in Benign Glomus Tumor.
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Seung Sam Paik, Eun Sun Kim, Young Chun Moon, Chan Kum Park, Moon Hyang Park, Jung Dal Lee
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Korean J Pathol. 1997;31(3):280-283.
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- The glomus tumor is a distinct neoplasm composed of modified perivascular smooth-muscle cells identical to those described in the glomus body. Malignant glomus tumor, also referred to as glomangiosarcoma, is exceedingly rare. It has been subdivided into locally infiltrative glomus tumor, glomangiosarcoma arising in a benign glomus tumor, and glomangiosarcoma arising in de novo. A few cases of malignant glomus tumor arising in a benign glomus tumor have been reported. A 55-year-old man underwent resection of a solitary nodule in the right shoulder area. The tumor was biphasic with a typical benign glomus tumor at the periphery and the central sarcomatous area composed of oval to elongated pleomorphic cells with a single prominent nucleolus and occasional mitotic figures. Both tumor components showed intense staining for vimentin, smooth muscle actin, and muscle specific actin. Herein, we report a case of a malignant glomus tumor arising in a benign glomus tumor with an immunohistochemical study and a review of literatures.
- Clear Cell Islet Cell Tumor of the Pancreas: An Immunohistochemical and Ultrastructural study.
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Seung Sam Paik, Young Ha Oh, Eun Kyung Hong, Moon Hyang Park, Jung Dal Lee
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Korean J Pathol. 1997;31(2):162-166.
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- A clear cell islet cell tumor of the pancreas is extremely rare and characterized by extensive clear cell components.
Electron microscopic and immunohistochemical findings are essential to prove that the mass with clear cells is an unusual manifestation of an islet cell tumor. Herein, we report a case of clear cell islet cell tumor of a 54-year-old woman with abdominal pain. The tumor was composed of polygonal clear cells arranged in nests, trabeculae, and ribbon pattern with the extensively fibrous stroma. These tumor cells showed strong reactivity for chromogranin and weak reactivity for somatostatin and glucagon. An electron microscope revealed that the important contributing factor of the clear cytoplasmic change was mainly due to an accumulation of lipid droplets, coupled with cytoplasmic swelling in some areas. Some tumor cells showed many endosecretory granules ranging from 111 to 297nm in diameter. In the clinical and immunohistochemical findings these granules were consistent with somatostatin granules in morphology and size.
- Ossifying Fibromyxoid Tumor of Soft Parts.
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Seok Hoon Jeon, Seung Sam Paik, Eun Kyung Hong, Moon Hyang Park, Jung Dal Lee
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Korean J Pathol. 1997;31(2):174-178.
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- An ossifying fibromyxoid tumor of soft parts is a rare, recently described, fibro-osseous neoplasm of uncertain histogenesis. It occurs most frequently within the subcutis or skeletal muscle of the extremities. Its biologic behavior is generally regarded as benign with at worst a locally aggressive clinical course. But, atypical and malignant variants have been recently reported. Herein we report a case of a benign ossifying fibromyxoid tumor which occurred in the left upper back of 41-year-old man. The tumor is composed of uniformly round or polygonal cells arranged in cords or nests which are separated by myxoid and hyalinzed fibrous matrix and associated with irregular bony trabeculae. The tumor cells are strong positive for vimentin. Ultrastructural findings and a review of literatures are added.
- Signet Ring Cell Variant of Invasive Lobular Carcinoma of Male Breast.
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Seung Sam Paik, Seok Hoon Jeon, Moon Hyang Park, Pa Jong Jung, Jung Dal Lee
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Korean J Pathol. 1997;31(2):179-181.
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- Lobular carcinoma of the male breast is very rare, because of the absence of lobules in the normal male breast.
Herein, a case of lobular carcinoma of the male breast with cellular features of signet ring cells is described. A 57-year-old man presented with a left breast mass.
Histologic examination showed classic invasive lobular carcinoma with in situ component. Most infiltrating tumor cells had a prominent signet ring cell appearance. The patient was phenotypically male and had fathered children.
There was no history of predisposing factors to breast lesion, such as hormone use or gynecomastia.
- Expressions of Epidermal Growth Factor Receptor, c-erbB-2 and p53 Protein as Useful Markers of Malignant Potential in a Transitional Cell Carcinoma of the Urinary Bladder.
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Gu Kong, Ki Yong Shin, Sun Jin Kim, Young Hyeh Ko, Hae Young Park, Young Nam Woo, Jung Dal Lee
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Korean J Pathol. 1997;31(1):51-58.
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- Transitional cell carcinoma(TCC) of the urinary bladder shows marked heterogeneity in biological behaviors. Evidence has accumulated that biological markers may provide significant information to predict the potential aggressiveness of TCC. We have assessed the expression of the epidermal growth factor receptor (EGF-R), c-erbB-2 and p53 proteins in 56 cases of TCC to investigate the prognostic significance of differential expression of these oncoproteins using an immunohistochemical method. We analysed the expression patterns of these oncoproteins according to tumor stage and grade. And we assessed the probability of progression-free survival in stage T1 tumors according to their expressions. Positive rates of EGF-R (>+3 staining intensity), c-erbB-2 (intense membrane staining) and p53 proteins (>20% positive cells) were 73.2%, 37.5% and 42.9%, respectively. Invasive tumors had significantly higher positive rates of all three factors than did superficial tumors (p<0.005 for EGF-R and c-erbB-2, p<0.05 for p53). High grade tumors had significantly higher positive rates of c-erbB-2 and p53 proteins (p<0.005). In superficial tumors, T1 tumors had higher positive rate of p53 protein compared with Ta tumors (p<0.05). Twelve cases of superficial tumors (34.3%) were positive for EGF-R and negative for c-erbB-2 and p53 proteins. Nine cases of superficial tumors(25.7%) were negative for all three factors. In invasive tumors, however, 42.5% of the cases were positive for all three factors. The overexpression of p53 protein was the only useful marker to predict the rapid progression in stage T1 tumors (p<0.05, log-rank test).
These results suggest that the differential overexpression of EGF-R, c-erbB-2 and p53 proteins could be useful to depict tumor aggressiveness of TCC of the urinary bladder.
And, the overexpression of a p53 protein may be a useful marker to predict the possibility of rapid progression in stage T1 tumors.
- Inflammatory Myofibroblastic Tumor in Posterior Mediastinum.
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Seung Sam Paik, Seok Hoon Jeon, Se Jin Jang, Moon Hyang Park, Jung Dal Lee
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Korean J Pathol. 1997;31(1):63-67.
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- Inflammatory myofibroblastic tumor(IMT) or inflammatory pseudotumor is a rare, solid tumor that most often affects children. This tumor is characterized by a spindle cell proliferation admixed with a variety of inflammatory cells.
Although it has disputed nosology, a distinctive fibroinflammatory and even pseudosarcomatous appearance have been well appreciated. Herein, we report a case of IMT in the posterior mediastinum in a 19-year-old girl with clinical findings. The immunohistochemical and ultrastructural studies on the tumor cells are reported, and their distinctive characteristics are discussed in details.
- The Significance of AgNOR Count in Body Fluid: Differential between reactive mesothelial cells & malignant cells.
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Seung Sam Paik, Eun Kyung Hong, Se Jin Jang, Moon Hyang Park, Jung Dal Lee
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Korean J Cytopathol. 1997;8(2):129-134.
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- To distinguish reactive mesothelial cells from malignant cells in body fluid, we applied silver staining of nucleolar organizer regions(AgNORs) to ethanol fixed cytologic preparations. Fifty aspirated samples of benign(22 cases) and malignant(26 cases) body fluids were studied using the one step silver staining method. Two cytologically atypical samples were also included in the study. In malignant cases the mean AgNOR count was 3.56+/-0.81, while in benign cases the mean AgNOR count was 2.02+/-0.33. The difference of AgNOR counts between these two groups were statistically significant(p<0.001). The mean of atypical cases was 2.91. Both were diagnosed as malignant in follow-up cytology. In malignant effusions, there is statistically significant difference in AgNOR counts between cells forming complex papillae or clusters and singly scattered cells(p<0.05), 3.29+/-0.95 and 3.83+/-0.55, respectively. We concluded that AgNOR count appears to be useful as a diagnostic tool especially when the cytologic differentiation is difficult.
- Fine Needle Aspiration Cytology of Pilomatrixoma.
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Seung Sam Paik, Dong Hoon Kim, How Jin Lee, Se Jin Jang, Moon Hyang Park, Jung Dal Lee
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Korean J Cytopathol. 1997;8(2):155-159.
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- Pilomatrixoma is a benign skin appendage tumor of hair matrix cell origin. The cytological appearance of this tumor may cause problems when attempting to establish a differential diagnosis with other neoplasms.
Herein we report the aspiration cytology findings of two cases of pilomatrixoma. One case was diagnosed as atypical cell clusters initially and the other was diagnosed as pilomatrixoma. On cytologic examination, both cases showed clusters of tightly arranged basaloid cells with an uniform appearance, scanty cytoplasm and round hyperchromatic nuclei.
There were histiocytes and multinucleated foreign body giant cells merged with the amorphous opaque orangeophilic materials of "ghost cells".
The differential diagnosis with other neoplasms is discussed.
- Localized Pulmonary Cryptococcosis Diagnosed by Fine Needle Aspiration Cytology: Report of a Case .
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Chan Kum Park, Wan Sup Kim, Geun Shin Lyu, Seok Chol Jeon, Jung Dal Lee
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Korean J Cytopathol. 1997;8(1):107-111.
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- Initial rapid diagnosis of primary pulmonary cryptococcosis(PPC) occurring in a immunocompetent host was made by transthoracic fine needle aspiration cytology of a solitary subpleural nodule.
Numerous refractile spherical organisms surrounded by a clear halo were demonstrated with haematoxylin-eosin and Papanicolaou stains. The organisms, 5 15 micrometer in diameter, were easily demonstrated with Gomori methenamine-silver stain. Many of the organisms showed narrow-base budding. Carminophilic cell walls were well demonstrated with mucicarmine stain.
- Epstein-Barr Virus in Korean Malignant Lymphomas.
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Young Hyeh Ko, Jung Dal Lee
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Korean J Pathol. 1996;30(11):1011-1017.
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- To determine the prevalence of Epstein-Barr virus infection in lymphoid neoplasms of various histology and location, the paraffin tissues of 74 non-Hodgkin's lymphomas and 13 Hodgkin's diseases were studied by EBER and BHLF RNA in situ hybridization as well as immunostaining using LMP-1, EBNA-2, and ZEBRA. As a control, non-neoplastic lymphoid tissues from the nasal cavity(10), lymph node(38) and Waldeyer's ring(12) were investigated. In non-neoplastic control, EBV genome was detected in none of 10 nasal mucosa, 6 of 38 lymph node, and 1 of 12 Waldeyer's ring. EBV-positive non-neoplastic lymphocytes expressed CD45RO in 2 cases and CD20 in 4 cases. Non-Hodgkin's lymphoma was positive for EBV in 37.8% of the cases in which T-cell lymphoma showed higher rate(56%) than B-cell lymphoma(15%), especially in nasal lymphoma(80%) and angiocentric lymphoma(63.6%). Hodgkin's disease was EBV positive in 38.4% of the cases. EBV genome in tumor tissue existed in latent form as well as in lytic form. LMP-1 was positive in 80% of Hodgkin's disease and 39% of non-Hodgkin's lymphoma in which EBV genome was detected.
EBNA-2 was expressed in 3 cases of non-Hodgkin's lymphoma.
On the basis of protein expression, most lymphomas belonged to type II latency. These results support that EBV is associated with pathogenesis of malignant lymphoma although its mechanism still awaits to be clarified.
- Polymerase Chain Reaction Analysis of Human Papillomavirus in Esophageal Squamous Cell Carcinoma with its Correlation to p53 mutation.
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Wan Seop Kim, Eun Kyung Hong, In Kyu Kim, Moon Hyang Park, Jung Dal Lee
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Korean J Pathol. 1996;30(11):1018-1026.
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- HPV infection has been implicated strongly in the pathogenesis of human squamous cell carcinoma(SCC). We analysed a series of 28 surgically removed, invasive squamous cell carcinoma of the esophagus by polymerase chain reaction to detect HPV DNA using consensus primers and 8 type-specific primers of HPV (6, 11, 16, 18, 31, 33, 35, 51). HPV 6, 31, 35 or 51 DNA were detected in 20 out of 28 cases (71.4%) of the esophageal SCCs. HPV 51 was the most frequently detected type, occuring in 13 out of 28 cases (46.4%). p53 immunohistochemical staining was also performed to demonstrate any relationship to HPV DNA positivity. It showed positivity in 16 out of 28(57.1%) esophageal SCCs, and HPV DNA and p53 positivity were concurrently detected in 11 out of 28 cases of SCCs. There was no significant inverse relation between HPV DNA positivity and p53 expression(p>0.05). Our results supported HPV involvement in esophageal squamous cell carcinoma, and suggested there may be another pathway not related to the p53-binding pathway in the carcinogenesis of esophageal SCCs by HPV.
- Gastrointestinal Adenomatous Polyposis Associated with Small Cell Neuroendocrine Carcinoma of the Rectosigmoid: A case report.
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Wan Seop Kim, Eun Kyung Hong, Kang Sik Kim, Kwang Soo Lee, Jung Dal Lee
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Korean J Pathol. 1996;30(11):1040-1044.
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- In adenomatous polyposis coli there are many colonic and extracolonic manifestations, and various combinations of these induce different clinical presentations and syndromes.
We experienced a unique case of adenomatous polyposis of the large intestine and stomach in a 39-year-old man. In the colon, small cell neuroendocrine carcinoma rather than adenocarcinoma had developed, which did not contain adenomatous or carcinomatous foci. The adenomatous polyps in the colon were all small and sessile with no cancerous or precancerous change two years after the resection of the symptomatic gastric adenomas, even though the gastric adenomas were larger and showed dysplastic change. We think this case is another variant of adenomatous polyposis syndrome.
- Expression of bcl-2 and c-myc Proteins in Epidermal and Melanocytic Tumors.
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Young Ha Oh, Chan Kum Park, Jung Dal Lee
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Korean J Pathol. 1996;30(9):810-818.
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- bcl-2 and c-myc protein expression were studied in 44 epidermal (8 seborrheic keratoses, 21 squamous cell carcinomas, and 15 basal cell carcinomas), and 26 melanocytic tumors(8 nevi, and malignant melanomas) by immunohistochemistry using the specific anti-bcl-2 and anti-c-myc monoclonal antibodies. 14 out of 15 basal cell carcinomas(BCC) (93.3%) showed expression of bcl-2 protein, 12 of which (85.7%) showed coexpression of c-myc protein. In the melanocytic tumors, 7 out of 8 nevi showed bcl-2 expression (87.5%). Five of these 7 cases (62.5%) also showed c-myc protein expression. Eight of 18 malignant melanomas(MM) (44.4%) showed expression of bcl-2 protein and 7 of these 8 cases (38.9%) also showed c-myc protein expression. All seborrheic keratoses and squamous cell carcinoma(SCC) were negative for bcl-2 proteins. 12 of 15 SCCs(80%) were positive for c-myc protein. In conclusion, bcl-2 and c-myc proteins were coexpressed in BCCs, nevi, and MMs. Coexpression of bcl-2 and c-myc proteins in these tumors was statistically significant(p<0.01), while no considerable differences of bcl-2 and c-myc expression were found between nevi and MMs. These results suggests that bcl-2 may cooperate with c-myc to promote tumorigenesis of BCCs, nevi, and MMs(p<0.01).
- Mucinous Adenocarcinoma of Anal Ducts.
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Young Ha Oh, Wan Seop Kim, Eun Kyung Hong, Moon Hyang Park, Jung Dal Lee
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Korean J Pathol. 1996;30(9):843-850.
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- Anal duct carcinoma is a rare tumor, and accounts for less than 5 percent of all anal cancers, which typically present a long-standing perianal fistulas. Some authors suggest that the fistulous tracts are congenital duplications of the lower end of the hind gut lined by rectal mucosa which is prone to malignant change to mucinous adenocarcinoma. It is usually a well differentiated mucinous (colloid) adenocarcinoma. The prognosis after wide excision of the rectum is relatively good. Since 1985, we have had three cases of anal duct carcinoma with well differentiated mucinous adenocarcinoma involving the posterior wall of the anus. Two patients had a long history of perianal fistula with mucinous discharge. There was no spread to the regional lymph node except one patient who had regional lymph node metastasis, and post-operative chemotherapy and radiation therapy were then given. All patients have no evidence of any recurrent problem at 16 months to 3 years following the surgical treatment. Because of their rarity and the failure of recognition at an early stage, we are presenting three cases to emphasize the characteristic features of this insidious, slow-growing carcinoma.
- EBV in Situ Hybridization Study for Cutaneous T-Cell Lymphomas.
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Chan Kum Park, Chang Woo Lee, Jung Dal Lee
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Korean J Pathol. 1996;30(8):699-705.
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- We studied 24 cases of cutaneous T-cell lymphomas and six cases of benign lymphoproliferative diseases of the skin (2 Jessner's lymphocytic infiltration, 2 pseudolymphoma, 2 lymphomatoid papulosis) for the presence of Epstein-Barr Virus(EBV) RNA, using the in situ hybridization(ISH) method.
Among the 24 cases of cutaneous T-cell lymphomas (CTCL), 18 cases including 12 cases of mycosis fungoides(MF) were primary CTCL, and the other 6 cases were secondary CTCL. The ISH study demonstrated a positive reaction for EBER probe in 6 out of the 24 cases(25%) of CTCL, and a negative reaction for BHLF nuclear RNA probe in all the cases studied.
Double-labelling immunohistochemistry/ISH studies revealed that the EBV positive cells were CD45RO positive and CD20 negative. EBV genome was not demonstrated in any benign lymphoproliferative diseases of the skin. Among the EBER positive cases, none of the 12 cases of MF demonstrated EBER signals, and 6 out of the 12(50%) cases of CTCL were positive for EBER probe. In conclusion, latent infection of EBV may play a role in the development of non-mycosis fungoides T-cell lymphomas involving the skin.
- Ureteral Fibroepithelial Polyp: A report of four cases (One case with nephrogenic adenoma).
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Won Mee Lee, Seung Sam Paik, Eun Kyung Hong, Moon Hyang Park, Jung Dal Lee
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Korean J Pathol. 1996;30(8):715-720.
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- Fibroepithelial polyps of the ureter are usually acquired rather than congenital. Most polyps are hamartomatous growths which tend to arise in the proximal portion of the left ureter. Most patients exibit either hematuria or persistent flank pain secondary to partial ureteral obstruction. Because of false positivity of urine cytology, as well as intravenous pyelogram, the correct diagnosis is confused with malignancy. Herein we report four cases of ureteral fibroepithelial polyp, which are associated with stones resulting in partial obstruction of the ureter. One of the four cases is associated with nephrogenic adenoma in the lamina propria of the adjacent ureter. The following report describes clinicopathologic findings of fibroepithelial polyp with review of literatures.
- Idiopathic Entero-colic Lymphocytic Phlebitis: A case report.
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Seung Sam Paik, Young Ha Oh, Eun Kyung Hong, Jung Dal Lee
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Korean J Pathol. 1996;30(6):533-538.
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- Localized enterocolic lymphocytic phlebitis is characterized by selective phlebitis involving the small to medium-sized veins and venules, infiltration exclusively by lymphocytes, and no other systemic vasculitis or inflammatory bowel disease. This vasculitis can be a rare cause of intestinal ischemia. We experienced a case of enterocolic lymphocytic phlebitis in a 72-year-old woman, who presented with abdominal pain and distension. The resected colon and terminal ileum showed striking lymphocytic phlebitis affecting the veins and venules of the bowel and mesentery which resulted in ischemic injury of the bowel. This vasculopathy was the only demonstrable cause of ischemia.
Arteritis and arteriolitis was not found. There is no clinical or laboratory evidence or a history of extraintestinal vasculitis. The etiology of this clinicopathological entity has not been elucidated. Herein, we report the clinicopathological findings in this patient who presented with ischemic intestinal necrosis caused by localized intestinal lymphocytic phlebitis associated with thrombosis.
- Alpha-Fetoprotein-Producing Carcinoma of the Gallbladder.
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Young Ha Oh, Haeng Ji Kang, Hyoung Guen Lee, Eun Kyung Hong, Yong Il Kim, Jung Dal Lee
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Korean J Pathol. 1996;30(5):453-456.
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- Alpha-fetoprotein (AFP) is a well-known tumor marker for hepatocellular carcinoma, hepatoblastoma, and yolk sac tumors. There are several studies on AFP-producing tumors that arose from the gastrointestinal tract, pancreas, lung, kidney, and urachal tract. AFP-producing carcinoma of the gallbladder is extremely rare. We report a case of AFP-producing carcinoma of the gallbladder without liver involvement in a 58-year-old man with a gallstone, on which clinical, morphologic, and immunohistochemical studies were performed.
- Cytologic Features of Glassy Cell Carcinoma of the Uterine Cervix: Three Cases Report.
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Seok Hoon Jeon, Seung Sam Paik, Won Mi Lee, Se Jin Jang, Yong Wook Park, Moon Hyang Park, Jung Dal Lee
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Korean J Cytopathol. 1996;7(2):197-201.
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- Glassy cell carcinoma is an unusual neoplasm of the uterine cervix that accounts for 1~2% of all cervical malignancy. It is a rapidly progressive and biologically aggressive disease with poor response to therapy. This tumor is considered to be a poorly differentiated mixed adenosquamous carcinoma.
The cytologic findings are characterized by tumor cells arranged predominantly in syncytial like aggregates and an inflammatory background. The tumor cells have moderate amounts of eosinophilic or amphophilic cytoplasm, which is often finely granular. The nuclei are relatively large and have fine chromatin with prominent eosinophilic nucleoli.
Cytologically, glassy cell carcinoma is most likely to be confused with large cell nonkeratinizing squamous cell carcinoma and with atypical reparative cells. Herein, we report three cases of glassy cell carcinoma of the uterine cervix diagnosed by cervicovaginal smear and confirmed by histologic section with review of literatures.
- Fine Needle Aspiration Cytology of Metastatic Wilms' Tumor in the Lung: Report of Two Cases.
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Wan Seop Kim, Nam Hoon Kim, Young Hyeh Koh, Moon Hyang Park, Jung Dal Lee
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Korean J Cytopathol. 1996;7(2):218-224.
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- We describe two cases of metastatic Wilms' tumor in the lung with emphasis on the cytologic features of specimens obtained by needle aspiration. One of them was extrarenal Wilms' tumor. The findings were correlated with the histopathologic fea- tures of the primary lesion. Cellular components in the fine needle aspiration cytology (FNAC) slides included blastemal, epithelial, stromal and inflammatory cells with immature tubular differentiation and rosette formation. Recognition of these cellular components in FNAC smears help in establishing FNAC diagnosis of Wilms' tumor. The blastemal cells were represented by small to medium sized cells with scanty cytoplasm having ill-defined borders and round to slightly oval nuclei with evenly dispersed chromatin and small marginated nucleoli. They were seen in our two cases. The differential diagnosis includes neuroblastoma, malignant lymphoma, malignant rhabdoid tumor, clear cell sarcoma, Ewing's sarcoma and embryonal rhabdo-myosarcoma. In conclusion, making a definite cytologic diagnosis of metastatic Wilms' tumor may be possible by light and electron microscopy and immunohi-stochemical staining. The above findings may contribute to the diagnosis of FNAC of metastatic Wilms' tumor.
- Fine Needle Aspiration Cytology of Acinic Cell Carcinoma of the Parotid Gland: A Case Report.
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Seok Hoon Jeon, Seung Sam Paik, Won Mi Lee, Moon Hyang Park, Jung Dal Lee
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Korean J Cytopathol. 1996;7(2):225-229.
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- We experienced a case of well-differentiated acinic cell carcinoma of the parotid gland in a 65 year-old woman, which was correctly diagnosed preoperatively by fine needle aspiration(FNA) cytology. FNA cytology smears showed clusters or sheets of monomorphic acinic cells having reticulated or finely vacuolated basophilic or acidophilic cytoplasm. The cellular population was homogeneous or slightly polymorphic, having centrally located, round nuclei with finely reticular chromatin and incon- spicuous nucleoli. Herein we report this case with its histologic features and review of literatures.
- Clinical and Histopathologic Study of Eosinophilic Cellulitis.
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Eun Kyung Kim, Chan Keum Park, Jung Dal Lee
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Korean J Pathol. 1995;29(3):334-342.
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- Eosinophilic cellulitis is a rare dermatosis originally described by Wells as "recurrent granulomatous dermatitis with eosinophilia", then called Wells' syndrome. The etiology is unknown, although a hypersensitivity mechanism is suspected. Flame figures are considered as a characteristic histologic feature of Wells' syndrome. To clarify the nature of eosinophilic cellulitis and its flame figures, the authors have reviewed five cases of eosinophilic cellulitis with its clinical and histopathologic findings. Cutaneous lesions were variable in appearance and was confused with angioedema, urticarial vasculitis, erydiema multiforme, morphea or granuloma annulare. Microscopically, early lesions (2-7 days) showed diffuse dermal eosinophilic infiltration with widespread degranulation, sometimes extended into the underlying muscle. Subepidermal bulla was present in one case.
Subsequently, granulomatous features with characteristic "flame figures" became apparent (several months). Collagen alteration by eosinophilic granules resulted in flame figure formation and a granulomatous response. In two patients, there were possible relationships between drug and flare-ups of eosinophilic cellulitis, but the others, no contributory precipitating factors were found. We think that eosinophilic cellulitis represents a severe anaphylactic hypersensitivity reaction to various stimuli showing characteristic histopathology with recurrent episodes and frequent hypereosinophilia in the peripheral blood.
- Non-Hodgkin's Lymphoma of the Uterine Cervix: 3 cases report.
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Chan Pil Park, Young Hyeh Ko, Jung Dal Lee, Moon Il Park, Kyung Tai Kim, Sam Hyun Cho
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Korean J Pathol. 1995;29(3):368-373.
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- Three patients with primary non-Hodgkin's lymphoma of the uterine cervix are reported and the literature is reviewed.
All the three patients in the current study presented with vaginal bleeding. They were found to have diffuse large cleaved cell lymphoma, one of which was multilobated variant with marked sclerosis. Histologically, differential diagnsis from undifferentiated small cell carcinoma, endometrial stromal sarcoma & other sarcomas was difficult and requires special stains including immunobistochemical study. Vaginal pap smears were diagnosed as 'class V; malignant lymphoma' in only one patient. Immunologically, two cases were beta-cell lineage and one case was T-cell lineage. All the patients were treated with chemotherapy only and showed good responses.
- A Case of Malignant Lymphoma Misdiagnosed as Focal Lymphoid Hyperplasia in the Esophagus.
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Sook Keum Chung, Young Hyeh Ko, Chan Keum Park, Jung Dal Lee
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Korean J Pathol. 1995;29(3):393-398.
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- Esophageal involvement by malignant lymphoma is extremely rare. A case of follicular lymphoma of the esophagus, misdiagnosed as focal lymphoid hyperplasia (pseudolymphoma) in a 72-year-old man is presented. The esophagogram revealed diffuse narrowing of the lumen in the middle and distal portion without ulceration. The resected esophagus showed mural thickening without any remarkable mucosal change.
Microscopically, the esophagus showed scattered follicular lymphoid aggregates in the submucosa, extending into periadventitial fat tissue. Most follicles were devoid of germinal center and consisted of loosely aggregated small cleaved cells without atypia. The surrounding stroma of the submucosa showed dense fibrosis entrapping the infiltrating small lymphocytes in a "indian-file" appearance. There were some reactive follicles with germinal center. In the lamina propria, many plasma cells and a few eosinophils were infiltrated. The gene rearrangement study showed rearranged band for Jk probe which confirmed monoclonal B-cell nature of infiltrated small lymphoid cells. The small cleaved lymphocytes arranged in follicles were positive for L26 and bcl-2 protein. This case demonstrated the necessity of immunophenotypic and gene rearrangement study in the diagnosis of pseudolymphoma in the digestive tract.
- Analysis of Transthoracic Fine Needle Aspiration Cytologic Diagnoses of Pulmonary Nodules.
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Chan Kum Park, Jung Dal Lee
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Korean J Cytopathol. 1995;6(2):133-139.
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- To evaluate the sensitivity and specificity of transthoracic fine needle aspiration cytology(TFNAC) in the preoperative diagnosis of pulmonary nodules, a retrospective analysis was carried out on a consecutive series of 200 TFNACs. They included 186 primary malignant tumors, 66 squamous cell carcinomas, 65 adenocarcinomas, 36 small cell carcinomas, 7 large cell carcinomas, 4 carcinoids, 8 others, 9 metastatic tumors, and 5 benign tumors. On cytohistologic correlation of malignant pulmonary tumors, the procedure had a sensitivity of 97.3% and a specificity of 100%. A 86.6% correct correlation between the cytologic and histologic diagnoses was achieved. Five out of the 7 undifferentiated large cell carcinomas, 10 out of the 65 adenocarcinomas, 2 out of the 36 small cell carcinomas, and 2 out of the 66 squamous cell carcinomas were turned out to be mistyped in cytologic diagnosis. We concluded that TFNAC is a highly sensitive and specific preoperative diagnostic procedure in the investigation of patients with discrete pulmonary nodules in whom the specific cell type of the malignant neoplasm has important implications in treatment modality and prognosis.
- Cytologic Features of Malignant Lymphoma of the Uterine Cervix: A case report.
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Nam Hoon Kim, Chan Kum Park, Young Hyeh Ko, Moon Hyang Park, Jung Dal Lee
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Korean J Cytopathol. 1995;6(1):76-79.
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- The uterine cervix is an uncommon site of primary non-Hodgkin's lymphoma (NHL). Although the cytologic findings of NHLs are well known, most cervicovaginal smear of uterine NHLs give lower diagnostic yield than common epithelial malignancy because abnormal cells do not appear in the sample in the absence of surface ulceration. Herein, we describe cytologic findings of a case of uterine cervical NHL which was initially diagnosed by cervicovaginal smear.
The tumor cells were relatively uniform, isolated, large-sized with scanty cytoplasm and round or indented nuclei. The nuclei had stippled chromatin and small nucleoli. Histologically and immunohistochemically the tumor was proven to be large cell lymphoma of T-cell lineage.
- Glomus Tumor of Stomach: A case report.
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Young Ha Oh, Chan Pil Park, Chan Kum Park, Sung Jun Kwon, Jung Dal Lee
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Korean J Pathol. 1994;28(6):669-672.
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- Gastric glomus tumor is an uncommon benign, submucosal neoplasm and does not require radical surgical procedure.
Because there are no specific clinical or radiologic features associated with the glomus tumor, it can be recognized only by its histologic characteristics. We report a 30-year-old woman who had 10 years history of epigastric hunger pain. Radiologically, a gastric submucosal tumor was discovered, which was suggestive of leiomyoma. Gastric antrectomy was performed. The tumor cells showed immunohistochemical and ultrastructural evidence of smooth muscle differentiation.
- Infantile Fibrosarcoma: A case report.
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Chan Pil Park, Geun Shin Lyu, Chan Kum Park, Jung Dal Lee
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Korean J Pathol. 1994;28(3):313-315.
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- Fibrosarcoma in newborns and infants, designated as congenital, infantile, or juvenile fibrosarcoma is an uncommon soft tissue neoplasm occurring most frequently during the first year of life. Infantile fibrosarcoma is associated with favorable clinical behavior that is markedly different from that of adult fibrosarcoma., We report a case of infantile fibrosarcoma occured in a 3-year-old boy presenting as a palpable mass in the left lower extremity since 3 months of life. Histologic findings of the tumor are similar to those of f ibrosarcomas in adult.
- Glycogen-Rich Clear Cell Carcinoma of Breast: A case report.
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Nam Hoon Kim, Wan Seop Kim, Young Hyeh Ko, Jung Dal Lee
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Korean J Pathol. 1994;28(3):316-318.
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- Glycogen-rich clear cell carcinoma of the breast is very rare(l -3% of breast cancer). It is defined as a tumor composed of more than 50% of optically clear, neoplastic cells, characterized by centrally located nuclei and abundant cytoplasm, being positive for periodic acid Schiff(PAS) and negative for periodic acid Schiff after diastase(D-PAS) treatment. In the absence of intraductal or in situ lobular carcinoma component, metastatic clear cell carcinomas of other organs should be considered as diagnostic possibilities. We report a case of glycogen-rich clear cell carcinoma arisen in a 62-year-old woman. The tumor revealed both solid and papillary pattern with intraductal component. The neoplastic cells had clear cytoplasm, which were PAS positive, D-PAS negative, mucicarmine negative and oil red 0 negative. More than 90% of tumor cells exhibited moderate staining for anti-estrogen receptor monoclonal antibody. Flow cytometric DNA analysis revealed diploid DNA content.
- Immunohistochemical Study of Upper Respiratory Tract Malignant Lymphomas with Features of Polymorphic Reticulosis.
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Jeong Ja Park, Tae In Park, Young Hyeh Ko, Jung Dal Lee
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Korean J Pathol. 1994;28(2):144-148.
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- Malignant lymphomas of the upper respiratory tract are relatively common in the Orient including Korea. They have a marked clinicopathologic and immunophenotypic diversity. We retrospectively reviewed 20 cases of malignant lymphomas with features of polymorphic reticulosis in the upper respiratory tract. Histopathologic findings consisted of polymorphism of lymphoid cells in 17 cases(85%), angiocentricity in 14 cases(70%), coagulation necrosis in 12 cases(60%), and epitheliotropism in 8 cases(40%). By Working Formulation, 14 cases(70%) were classified as diffuse large cell type, 4 cases(20%) as diffuse mixed small cleaved and large cell type, one case as immunoblastic type, and one case as anaplastic large cell type. On immunostaining, one showed B-cell phenotype and 19 cases showed T-cell phenotype. The B-cell type was histologically diffuse large cell type. From these results, we concluded that polymorphic reticulosis is a type of peripheral T-cell lymphoma with angiocentricity.
- Immunohistochemical Study for Ki-1 and EMA Antigens in Large Cell Lymphoma including Anaplastic Large Cell Lymphoma.
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Soon Ae Oak, Young Hyeh Ko, Jung Dal Lee
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Korean J Pathol. 1994;28(2):135-143.
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- To evaluate the frequency of EM A and Ki-I antigen expression in the large cell lymphoma and to define the histologic characteristics of Ki-1 positive anaplastic large cell lymphoma, 40 cases of malignant lymphoma, diffuse large cell type were immunostained by Ki-I and EMA monoclonal antibodies. Eight cases of large cell lymphomas expressed EMA, among which 4 cases were positive for Ki-I antibody as well. The positive rate for EMA was much higher in T cell lymphomas than in B cell lymphomas. Among 4 cases of Ki-I positive lymphomas, 2 cases showing membrane staining of Ki-1 with prototypic histologic feature of anaplastic large cell lymphoma were classified as Ki-1 positive anaplastic large cell lymphoma(ALCL). Ki-I positive ALCL were T-cell in one and non-T, non-B cell type in the other, respectively.
The remaining 2 cases of Ki-1 positive lymphomas showing cytoplasmic staining were classified as both B-cell centroblastic/centrocytic lymphoma and T-cell pleomorphic large cell lymphoma.
- Limb-Body Wall Malformation Complex: Two autopsy cases and its pathogenesis.
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Geun Shin Lyu, Nam Hoon Kim, Eun Kyung Hong, Jung Dal Lee
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Korean J Pathol. 1993;27(6):638-644.
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- Limb-body wall malformation complex(LBWC), also know as the amniotic band syndrome, is a poorly defined, sporadic group of congenital anomaly characterized by a collection of protean fetal malformation, deformation and disruption.
Accurate diagnosis is often difficult because of its variable presentation pattern and the absence of exactly same case. We report two autopsy cases. One revealed body wall, cardiac, and craniofacial anomalies with anencephaly, and amniotic adhesive band attached to craniofacial defect of the fetal part without evidence of amniotic rupture. The other exibited abdominal wall defect with omphalocele, visceral, postural, and limb anomalies together with neural tube defect in the lumbosacral region. The pathogenesis of this syndrome was discussed in detail.
- Retroperitoneal Mucinous Tumor: Report of two Cases.
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Eun Kyung Kim, Seong Ran Hong, Hy Sook Kim, Young Hyeh Ko, Jung Dal Lee
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Korean J Pathol. 1992;26(6):632-634.
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- Primary retroperitoneal mucinous tumor is very rare. In the worldwide literature, only 14 cases have been reported.
Herein, we report two cases of retroperitoneal mucinous tumor found at laparotomy. The patients were females, aged 24 and 21 years, respectively. They had bilateral normal ovaries. Histologically, one was mucinous cystadenoma and the other showed borderline histology. The connective tissue wall resembling ovarian stroma was noted in one case. The pathogenesis was discussed.
- Gastric Choriocarcinoma and Endodermal Sinus Tumor in Collision Tumor.
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Eun Kyung Kim, Eun Kyung Hong, Kwang Soo Lee, Jung Dal Lee
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Korean J Pathol. 1992;26(4):405-410.
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- Both primary choriocarcinoma and endodermal sinus tumor of the stomach are very rare entities. Combination of these two tumors is even rarer, and only a single such case has been reported in English literature. The case had gastric adenocarcinoma in addition to these tumors. We experienced a case of combined, pure choriocarcinoma and endodermal sinus tumor in the stomach of a 74 year-old man. He had no gonadal or any other primary tumor. Huge exophytic tumor was located in the lesser curvature of the body. Two components of the tumor was separated and clearly defined. Human chorionic gonadotropin(HCG) was demonstrated in serum and in tissue sections. Alpha-fetoprotein(alpha-FP) was also demonstrated in serum and in tissue sections. Alpha-fetoprotein(alpha-FP) was also elevated in the serum. Possible tumor origin was speculated.
- Papillary Craniopharyngiona: A report of two cases.
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Gu Kong, Eun Kyung Hong, Jung Dal Lee
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Korean J Pathol. 1992;26(2):171-174.
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- Two cases of suprasellar papillary craniopharyngioma are presented. The tumors are exclusively composed of well-formed papillary squamous epithelium and show morphologic homogeneity. There is no palisading basal layer in squamous epithelium. Clinical and radiologic findings, exclusive occurrence in adult and lack of calcification, are much different from conventional craniopharyngioma.
Differences between papillary craniopharyngiom and conventional craniopharyngioma are discussed.
- Primary Malignant Hemangiopericytoma of the Lung: A case report.
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Jung Hee Kang, Eun Kyung Hong, Chan Keum Park, Jung Dal Lee
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Korean J Pathol. 1992;26(1):66-70.
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- Primary pulmonary hemangiopericytoma is a rare, potentially malignant tumor and assumes more malignant course than that originated in the soft tissue. It can be asymtomatic until attaining a large size within the lung. We report a case of malignant hemangiopericytoma of the lung in a 29 year old man. It represented as a sharply demarcated, huge homogeneous opaque mass in the right upper lobe. The cytologic and histologic features were that of malignant hemangiopericytoma.
- Percutaneous fine needle aspiration cytology of malignancies of the pancreas.
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Jung Dal Lee, Keun Shin Kyu, Jin Seok Ko, Chul Yong Lee
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Korean J Cytopathol. 1992;3(2):37-51.
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- No abstract available.
- Morphometric Study on Mucinous Tumors of the Ovary.
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Joo Seub Keum, Jung Dal Lee
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Korean J Pathol. 1991;25(4):305-317.
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- Mucinous tumors of the ovary are the most common tumors arising from the common epithelium of the ovary in Korean.
Distinguishing the tumor with borderline malignancy from mucinous cystadenocarcinoma is very important in determining proper therapeutic modalities and prognosis. Authors have undertaken morphometric analysis of various parameters from both borderline lesions and carcinomas of mucinous nature of the ovary. In each, five cases of the borderline and malignant tumors were subjected to be evaluated. Various cytologic and histologic parameters were analyzed using Kontron IBAS-I. 1) The most helpful parameter-for differentiation between borderline and malignant mucinous tumors is cell concentration (sensitivity 80%, specificity 80%). The discrimination value is more than 35 cells per 100 micrometer of the basement membrane length. If the cellular concentration is higher than the discriminating value, that indicates malignancy. 2) Tumor cell height, though it is other parameter of stratification, is not helpful for differentiation of the two lesions. 3) Cytologic atypia, either in size or in form, can not be a criterion distinguishing the borderline from malignancy. 4) Papillary growths can not be a criterion of either borderline and malignant lesions. 5) The degree of irregularity at tumor-stroma interface is not helpful for differentiation between borderline and malignancy.
- Cardiac Fibroma of the Ventricular Septum: A case report.
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Byung Tae Park, Se Jin Jang, Moon Hyang Park, Jung Dal Lee, Hyo Jin Lee
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Korean J Pathol. 1991;25(1):37-41.
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- This is an autopsy case of a 6 month old girl who suddenly died of respiratory distress during sleep. She had suffered from mild but frequent episodes of common cold and was treated for eczema for several days. At autopsy, the heart was enlarged and weighed 100 gm. A firm and gray-white tumor, measuring 4.5 x 3.8 x 2.8 cm, was located in the interventricular septum and encroached upon the wall of left ventricle. The mass was well demarcated but was not encapsulated. Neither necrosis nor calcification was present. Microscopically the tumor was composed of haphazardly arranged bundles of collagen fibers and fibroblasts. Myocardial cells are intermingled with the fibroblasts at the margin of the tumor. Massive edema of the lung and congestion of the liver and spleen were pronounced.
- Fine needle aspiration cytology on solitary fibrous tumors of the pleura.
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Joo Seob Keum, Jung Dal Lee
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Korean J Cytopathol. 1991;2(2):134-141.
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Abstract
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- No abstract available.
- Fine needle aspiration cytology of thymic carcinoid tumor: a case report.
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Gu Kong, Jung Dal Lee
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Korean J Cytopathol. 1991;2(2):142-147.
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Abstract
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- No abstract available.
- Cytologic features of Langerhan's cell histiocytosis.
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Geun Shin Lyu, Young Hyeh Ko, Moon Hyang Park, Jung Dal Lee
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Korean J Cytopathol. 1991;2(2):153-159.
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Abstract
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- No abstract available.
- Cytologic findings of Hodgkin's disease with special emphasis on Reed-Sternberg cells and their variants.
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Young Hyeh Ko, Chan Pil Park, Jung Dal Lee
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Korean J Cytopathol. 1991;2(1):1-7.
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- Cytologic findings from five cases with variable types of Hodgkin' disease were reviewed with special emphasis on the Reed-Sternberg (R-S) cells and their variants. Typical R-S and Hodgkin's cells were mono- or binucleated, and nuclei had rounded smooth contour. Acidophilic prominent nucleoli with perinucleolar halo were conspicuous. In comparison to typical Reed-Sternberg cells, L & H (lymphocytic and histiocytic) cells in the lymphocyte predominant type tended to show pop-corn like irregular nuclear contour and to lack the prominent nucleoli. Lacunar cells in the nodular sclerosis type had multilobated nuclei with prominent acidophilic nucleoli. There was no prominent perinucleolar halo in L & H and lacunar cells. In conjuction with the number of Reed-Sternberg cells and back ground findings observed on the smears, the characteristic features of R-S cells and their variants allowed to make typing of Hodgkin's disease.
- Cytologic features of glassy cell carcinoma of the uterine cervix.
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Gu Kong, Eun Kyung Kim, Eun Kyung Hong, Jung Dal Lee
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Korean J Cytopathol. 1991;2(1):62-66.
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Abstract
- Glassy cell carcinoma is an unusual neoplasm of the uterine cervix with highly aggressive clinical behavior. On cervico-vaginal smear examination, the tumor has well confused of atypical repair cell of the endocervix.
Recently, we have experienced two cases of glassy cell carcinoma of the uterine cervix, diagnosed on cervico-vaginal smears and confirmed on following histologic sections. The cervico-vaginal smears revealed abundant clusters with well defined boarders. The cell clusters were composed of large tumor cells. The tumor cells had distinct granular cytoplasm and eosinophilic macronucleoli.
Characteristic cytologic features of this tumor were discussed in view of differential diagnosis.
- Cytologic Study of Sputum and Bronchial Secretions in Endobronchial Tuberculosis.
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Suek Yul Choi, Gu Kong, Jung Dal Lee
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Korean J Pathol. 1990;24(3):197-203.
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- Endobronchial tuberculosis is granulomatous inflammation of the bronchial mucosa characterized by bronchial ulceration due to caseous necrosis. There is a good chance to expectorate cellular components of granulomas in the sputum.
The author studied a cytologic series from 46 patients with endo-bronchial tuberculosis confirmed on fiberoptic bronchoscopic biopsy. The cytologic series consisted of 32 sputa, 41 washings, and 17 bronchial brushings, and were carefully screened for elongated epithelioid cells, Langhan's type giant cells, other multinucleated giant cells and caseous material. Elongated epithelioid cells were demonstrated in 9 sputa (28.1%), 30 bronchial washings (73.2%) and 11 brushing smears (64.7%). Langhans' giant cells were observed in two of 32 sputa (6.2%), six of 41 bronchial washings (14.6%) and four of 17 bronchial brushings (23.5%). The caseous materials were noted in 19 of 32 sputa (59.4%), 32 of 41 bronchial washings (78.0%), and 14 of 17 bronchial burshings (82.4%). It appeared that the pertinent cellular components of granulomas in sputa or bronchial secretions indicated a strong evidence of endobronchial tuberculosis of the lung.
- Solid and Papillary Epithelial Neoplasm of the Pancreas Diagnosed by Percutaneous Fine Needle Aspiration Biopsy.
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Chan Kum Park, Jung Dal Lee
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Korean J Pathol. 1990;24(3):304-309.
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- Solid and papillary epithelial neoplasm of the pancreas is a rare, low grade malignant tumor of adolescence. The tumor we described was diagnosed by following preoperative percutaneous fine needle aspiration biopsy and confirmed by tissue examination. Characteristic cytologic findings were monotonous cells arranged in papillary fronds, acinus, and cords in necrotic and hemorrhagic backgrounds. Occasional foamy histiocytes and hyaline globules were present. The cytoplasm of the tumor cells were moderate in amount, pale eosinophilic or vacuolated with distinct borders. The nuclei were centrally located and round. There were one or two small nucleoli and finely granular chromatin throughout the nucleus.
- Atypical Condyloma of Uterine Cervix: It's Cytological Similarity to Squamous Cell Carcinoma.
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Chan Kum Park, Myung Sook Kim, Jung Dal Lee
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Korean J Pathol. 1990;24(3):310-315.
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- Atypical condyloma is a variant of flat condyloma characterized by the presence of atypical koilocytes having large hyperchromatic, smudged and often bizarre nuclei.
Atypical condyloma can be frequently misdiagnosed on cytologic smear and on tissue sections by its marked cellular atypia, as high grade dysplasia, in situ or even invasive squamous cell carcinoma. We described two cases of atypical condyloma of the female genital tract. The cytologic features and histologic changes were reminiscent of those of invasive squamous cell carcinoma and severe degree of dysplasia of the uterine cervix. The differential findings between atypical condyloma and squamous cell carcinoma were discussed in detail.
- Morphometric Study on Cervical Intraepithelial Neoplasia.
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Jae Dong Cho, Byung Tae Park, Jung Dal Lee
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Korean J Pathol. 1990;24(3):267-274.
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- Cervical intraepithelial neoplasia in human consist of dysplasia of various developmental stages and squamous cell carcinoma in situ of various types. These lesions can be diagnosed cytologically on cervico-vaginal smears, although the diagnostic reproducibility is limited. To obtain the objects morphologic distinction between normal squamous epithelial cell in different maturation, different stages of dysplastic cells and varieties of in situ carcinoma cells, Kontron IBAS-1 imaging analyzer was applied for the measurement of nuclear and cytoplasmic areas of each categorised cells. The followings are results obtained: 1) Nuclear and cytoplasmic areas of superfical (36.9 micrometer2, 2319.9 micrometer2) intermedicate (45.7 micrometer2, 2989.7 micrometer2) and parabasal cells (50.8 micrometer2, 432.7 micrometer2) of normal squamous epithelium origin are mostly distinctive between cell types.
However, cytoplasmic areas of both superficial and intermediate cells and nuclear areas of both intermediate and parabasal cells are not significantly different. 2) Normal squamous cells and various dysplastic cells show obvious difference in their nuclear and cytoplasmic areas, while difference between cytoplasmic areas of both parabasal (432.7 micrometer2) and severe dysplastic cells (409.7 micrometer2) are not statistically significant. 3) No statistical difference is observed in between nuclear areas of both moderate dysplastic (112.3 micrometer2) and severe dysplastic cell (117.6 micrometer2). 4) Varieties of carcinoma in situ cells and severe dysplastic cells are in difference in their nuclear and cytoplastic areas, whereas nuclear areas from both in situ carcinoma cells (95.3 micrometer2) of large cell type and severe dysplasia (117.6 micrometer2) are not distinctive. The results lead the author to consider that the morphometric analysis for various parameters of cell constituents are of value in making objective distinction between cells from cervical intraepithelial neoplasia in human.
- Correlation between Histologic Differentiation and Prognosis of Prostate Adenocarcinoma.
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Se Jin Jang, Jung Dal Lee
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Korean J Pathol. 1990;24(3):243-253.
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- The authors reviewed clinical data and 50 pathologic specimens from 41 patients of prostate adenocarcinoma filed in the Department of Pathology, Hanyang University school of Medicine, in order to evaluate correlation between clinical stages and histopathologic grades of prostate adenocarcinoma. Each of five currently used grading systems were compared with clinical stages of prostate adenocarcinomas. The followings results were obtained: All of the grading systems were relatively well correlated with clinical progression of the tumon. Histologic grading systems including Gleason's grading system, Gleasons scoring system and M.D. Anderson system showed better correlation than cytologic grading system of Mostofi. Gaeta gradings system regarding both histologic and cytologic aspects of the carcinoma showed good correlation to clinical stage with correlation coefficient of 0.654. Combined scoring system of cytologic and histologic grades (Mostofi-M.D. Anderson combined scoring system) showed better correlation to the clinical stage than single individual grading s system. The author conclued that Gleasons histologic grading system with cytologic characteristics of tumor cells would represent best parameter of clinical progression of the prostate adenocarcinoma.
- Ependymoma Containing Cartilage: A case report.
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Eun Kyung Hong, Jung Dal Lee
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Korean J Pathol. 1990;24(1):77-81.
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- The presence of cartilage in a glial tumor is exceptional.
It frequently occurs in ependymoma of midline location in young child nuder 5 years of age. The mechanism of cartilage and bone formation in ependymoma is thought to be either metaplastic transformation from mesenchymal tissue or direct transformation from the neoplastic glial cells. A case of ependymoma containing cartilage and bone is reported. The patient is a 4 year-old girl, having calcified mass in the 4the ventricle and cerebellar vermis. The pathogenesis of cartilage formation in this ependymoma is more likely to support the mataplastic theory.
- Carcinoid Tumor of the Uterine Cercix: A light and electron microscopic study of two cases.
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Moon Hyang Park, Jung Dal Lee, Yoon Young Hwang
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Korean J Pathol. 1990;24(1):70-76.
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- Two cases of carcinoid tumor of the uterine cervix were reported with emphasis on the histologic, cytologic, histochemical and electron microscopic appearance of tumor cells. Based on the light microscopic findings, one case was a well differentiated carcinoid with acinus formation, and the other was a poorly differentiated anaplastic type, being composed of small cells similar to those of oat cell carcinoma of the lung. Both tumors demonstrated scattered argyrophilic cells on Grimelius stain, and contained neurosecretory granules on electron microscopy. They were in stages II b and IV, respectively, at the time of presentation. The latter patient was treated with vinblastin, platinol and bleomycin, but died in 9 months after the initial diagnosis. The former was lost to follow-up study. Importance of distinction between this highly malignant tumor and other varieties of cervical cancer was emphasized.
- Cytologic Features of Endometral Papillary Serous Carchinoma.
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Gu Kong, Eun Kyoung Hong, Jung Dal Lee
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Korean J Cytopathol. 1990;1(2):121-128.
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- Endometrial papillary serous carcinoma (EPSC) is a distinct variant of endometrial adenocarcinoma that histologically resembles ovarian serous papillary adenocarcinoma and has an aggressive clinical course. Usually, the tumor is diagnosed at the advanced stage. The tumor has well confused with metastatic ovarian tumor of identical histology. Diagnosis of EPSC should be considered when the cervico-vaginal smear reveals numerous papillary clusters of tumor cells with macronucleoli and psammoma bodies.
Recently, we have experienced two cases of EPSC diagnosed on cervico-vaginal smears, which revealed characteristic cytologic features including numerous papillary clusters of tumor cells with macronucleoli. The cytologic diagnoses were confirmed on histologic sections.
- Cytologic Study of Thymoma.
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Gu Kong, Se Jin Jang, Jung Dal Lee
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Korean J Cytopathol. 1990;1(1):36-42.
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- The fluoroscopy-guided fine needle aspiration biopsy has been gaining widespread acceptance as a rapid and effective method to make a pre-operative diagnosis of mediastinal tumors including thymoma, malignant lymphoma, and metastatic carcinoma. Although thymoma is a most common tumor of the superior mediastinum, most cytopathologists are not experted in cytologic diagnosis of this tumor because of limited experience. In order to define the diagnostic cytologic features of thymoma, we have retrospectively reviewed imprinting smears and corresponding tissue sections from four cases of this tumor.
All cases revealed an apparent biphasic pattern of epithelial cell clusters and lymphocytes with occasional branching capillary fronds extending from three dimensional epithelial cell clusters. Epithelial cell clusters predominated in one case and lymphocytes in two cases. Mixed epithelial cell and lymphocyte type represented in one of four cases.
In the lymphocyte predominant type, the presence of epithelial cell clusters and small mature lymphocytes are helpful features to differentiate from a malignent lymphoma.
- Fine Needle Aspiration Biopsy Cytology of Breast Tumors.
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In Sook Kim, Jung Dal Lee
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Korean J Cytopathol. 1990;1(1):51-59.
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- Fine needle aspiration biopsy cytology (FNA) for diagnosis of a variety of breast tumors has been proven to be a simple, sate, and cost saving diagnostic methodology with high accuracy.
Cytologic specimens from 1,029 fine needle aspirations of the breast during last 3-year period were reviewed and subsequent biopsies from 107 breast lesions were reevaluated for cytohistological correlation.
FNA had a sensitivity of 81.6% and a specificity of 98.3%.
One out of 107 cases biopsied revealed a false positive result (0.9%) and the case was due to misinterpretation of apocrine metaplastic cells in necrotic background as malignant cells.
A false negative rate was 8.4% (9 of 107 cases biopsied).
Six of 9 false negative cases were resulted from insufficient aspirates for diagnosis, and remaining three of 9 false negative cases revealed extensive necrosis with no or scanty viable cells on smears.
The results indicate that for reducing false positive and false negative rates of FNA, an experienced cytopathologist and a proficient aspirator are of great importance.
- Pathologic Study on Carcinomas of Extrahepatic Biliary Tract.
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Byung Tae Park, Eun Kyung Hong, Jung Dal Lee
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Korean J Pathol. 1989;23(3):311-321.
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- The authors reviewed surgical materials from 20 patients with carcinoma of the extrahepatic biliary system, and a correlation between macroscopic appearance of the tumors with various clinical features and histopathologic findings was made. Microscopically, the tumors were classified into four types; Four (21%) patients had polypoid tumors, six (32%) had nodular growths, five (26%) were scirrhous constricting in type, and four (21%) had diffusely infiltrating type. Histologically all the differentiation in two cases. The degree of differentiation of the tumors was classified into 3 types: 11 (55%) patients were well differentiated, 3(15%) were moderately well and 6(30%) were poorly differentiated. All polypoid tumors were well differentiated and had low stage. No correlation in the degree of differentiation of the tumor with the stage was present. No correlation in clinical symptoms, duration of symptoms, laboratory findings with morphologic findings of the tumors was noted.
- Disseminated Deciduosis Peritonei.
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Moon Hyang Park, Chan Kum Park, Jung Dal Lee
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Korean J Pathol. 1988;22(2):159-163.
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- Gross deciduosis in pregnancy is rare. A case of disseminated deciduosis peritonei studied by light and transmission electron microscopy is reported. The pathogenesis of deciduosis peritonei and relationship with leiomyomatosis peritonealis disseminata are discussed in view of the present findings and those previously reported.
- Human Papillomavirus infection in Cervical Intraepithelial Neoplasia: A Comparative Histopathological and Immunohistochemical Study.
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Chan Kum Park, Moon Hyang Park, Jung Dal Lee
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Korean J Pathol. 1986;20(3):255-262.
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- One hundred twelve cases of cervical intraepithelial neoplasia (CIN) were reviewed to detect the condylomatous lesion characterized by koilocytotic cells. Condylomatous lesions were present in 12 cases (30.8%) of 39 cases with mild dysplasia, 3 cases (15.0%) of 20 moderate dysplasia, 2 cases (13.3%) of 15 severe dysplasia and 4 cases (10.5%) of 38 cases with carcinoma in situ. These 21 cases with condylomatous lesions were subjected to the study on demonstration of human papillomavirus (HPV) antigen with peroxidase antiperoxidase reaction and 6 simple condylomatous lesions of the uterine cervix were included for control. Twenty seven cases with simple cervical condyloma and condylomatous lesions associated revealed 22 cases of flat type, 3 cases of exophytic type, 1 spiked type, and 1 inverted type. Cells showing a positive reaction for HPV antigen were identified in 5 cases (55.6%) of 27 cases with condylomatous lesions. HPV antigen positive nuclei were found chiefly in koilocytotic cells. The prevalence of HPV antigen positive cells was well correlated with the extent and intraepithelial level of the koilocytotic changes. The results of this study provide a confirmation of the presence of HPV antigens in CIN, and suggest that the HPV may be an important factor in the etiology of CIN.
- Aspiration Biopsy Cytology of Malignant Fibrous Histiocytoma.
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Moon Hyang Park, Eun Kyung Hong, Jung Dal Lee
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Korean J Pathol. 1986;20(3):332-335.
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- Cytologic findings of malignant cells obtained by fine needle aspiration from a huge retroperitoneal malignant fibrous histiocytoma were described. The smears contained numerous malignant cells, isolated or in clusters, in a bloody background. The malignant cells had abundant pleomorphic foamy or acidophilic cytoplasm with occasional multilobated vesicular nuclei and prominent nucleoli. Dual differentiation, both histiocytic and fibroblastic types, and neutrophilic inflammatory background were diagnostic of this neoplasm. The report indicated that study of aspiration cytology specimen from a soft tissue tumor was a valuable adjunct to histologic examination.
- Aggressive Osteoblastoma.
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Yong Koo Park, Hyung Bae Moon, Dong Kyuen Lee, Dae Moo Shim, Jung Dal Lee
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Korean J Pathol. 1986;20(2):235-239.
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Abstract
- Osteoblastomas were originally thought to be lesions that could be controlled with minimal local therapy, including curettage. However, at least some of the osteoblastomas with an unexpectedly active clinical course had histologic features which differed from ordinary osteoblastomas, and the term aggressive osteoblastoma was given to these lesions. In the aggressive osteoblastoma the osteoblasts are cytologically atypical. In addition, the well organized trabecular patterns of typical osteoblastoma is partly lacking, especially in the areas that are rich in atypical osteoblasts. The case report deals a case of aggressive osteoblastoma of the left iliac wing in a 44 year old male.
The interesting radiologic manifestationa(plain x-ray CAT and radionuclide bone scan) and characteristic histologic findings are presented along with review of pertinent literatures.
- Congenital Absence of Intestinal Musculature Associated with Long Segment Hirschsprung's Disease.
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Chan Kum Park, Moon Hyang Park, Jung Dal Lee, Poong Man Jung
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Korean J Pathol. 1986;20(2):199-202.
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- Intestinal obstruction is the commonest cause for emergency surgical intervention in the newborn. An extremely rare cause of intestinal obstruction in the neonate is a congenital abnormality consisting of segmental absence of intestinal musculature with intact serosa and mucosa. This report represents not only the fourth reported case of this anomaly but also the first case associated with long segment Hirschsprung's disease in English-written literatures.
- Recurrent Malignant Fibrous Histiocytoma Reminiscent of Clear Cell Sarcoma.
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Chan Kum Park, Jung Dal Lee
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Korean J Cytopathol. 1985;19(4):442-445.
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- This is a case of recurrent malignant fibrous histicytoma, histologic features of which are reminiscent of a clear cell carcinoma of soft tissue or myxoid liposarcoma. The tumor recurred 2 years and 10 months after the initial removal of the primary tumors in the lateral aspect of the left tigh.
In view of histogenesis of malignant fibrous histiocytoma, possibility of recurrent tumor with a wide range of histologic features including clear cell type is discussed.
Pertinent clinical history with review of the initial tumor is mandatory for a definite assessment of histologic feature of recurrent malignant fibrous histiocytoma.
- Lipodystrophia Centrifugalis Abdominalis Infantilis: A case report.
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Chan Kum Park, Jung Dal Lee, Jae Hong Kim
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Korean J Cytopathol. 1985;19(2):236-237.
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- Lipodystrophia centrifugalis abdominalis infantilis, an typical form of progressive lipodystrophy, is a disease mainly decribed in japanese infants. We report a case of lipodystrophia centrifugalis abdominals infantilis in Korean infant. The patient is a 2 year-old-girl with a coin sized well defined depressed lesion with surrounding redness and scaly changes in the right inguinal region. The skin from the depressed lesion revealed changes similar to those originally described by Imamura et al.
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