Journal of Pathology and Translational Medicine

Mee Sook Roh

22 Articles

The Interobserver Variability for Diagnosing Pulmonary Carcinoid Tumor.: Chang Hun Lee, Hee Kyung Chang, Hyoun Wook Lee, Dong Hoon Shin, Mee Sook Roh; Korean J Pathol. 2010;44(3):267-271.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.3.267

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BACKGROUND
Although the grade of pulmonary carcinoid tumor is routinely reported in pathology practice, there is a paucity of data on the level of agreement between pathologists.
METHODS
Data for 30 cases of surgically resected pulmonary tumors diagnosed as carcinoid tumors (19 typical carcinoids [TCs] and 11 atypical carcinoids [ACs]) were retrieved from four university hospitals. These cases were independently evaluated by five pathologists and were classified according to the 2004 World Health Organization (WHO) classification. Agreement was regarded as "unanimous" if all five pathologists agreed, and as a "majority" if four agreed. The kappa statistic was calculated to measure the degree of agreement between pathologists.
RESULTS
Unanimous agreement was achieved for 50.0% and a majority agreement for 83.3% of the 30 cases. The range of the kappa values extended from 0.37 to 0.89. After a consensus meeting, there was disagreement between the original diagnosis by each institute and the consensus diagnosis by the five pathologists for 40.0% of the 30 cases. Based on the consensus diagnosis, the agreement was greater for TCs than that for ACs.
CONCLUSIONS
Discriminating carcinoid tumors is subject to interobserver variability. This study indicates that there is a need for more careful standardization and application of diagnostic criteria for making the diagnosis of pulmonary carcinoid tumor.

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Limited additive value of the Ki‐67 proliferative index on patient survival in World Health Organization‐classified pulmonary carcinoids
Dorian R A Swarts, Martina Rudelius, Sandra M H Claessen, Jack P Cleutjens, Stefan Seidl, Marco Volante, Frans C S Ramaekers, Ernst J M Speel
Histopathology.2017; 70(3): 412. CrossRef
Interobserver Variability for the WHO Classification of Pulmonary Carcinoids
Dorian R.A. Swarts, Robert-Jan van Suylen, Michael A. den Bakker, Matthijs F.M. van Oosterhout, Frederik B.J.M. Thunnissen, Marco Volante, Anne-Marie C. Dingemans, Marc R.M. Scheltinga, Gerben P. Bootsma, Harry M.M. Pouwels, Ben E.E.M. van den Borne, Fran
American Journal of Surgical Pathology.2014; 38(10): 1429. CrossRef
Lung parenchymal invasion in pulmonary carcinoid tumor: An important histologic feature suggesting the diagnosis of atypical carcinoid and poor prognosis
Sang Yun Ha, Jae Jun Lee, Junhun Cho, Jiyeon Hyeon, Joungho Han, Hong Kwan Kim
Lung Cancer.2013; 80(2): 146. CrossRef
CD44 and OTP Are Strong Prognostic Markers for Pulmonary Carcinoids
Dorian R.A. Swarts, Mieke E.R. Henfling, Leander Van Neste, Robert-Jan van Suylen, Anne-Marie C. Dingemans, Winand N.M. Dinjens, Annick Haesevoets, Martina Rudelius, Erik Thunnissen, Marco Volante, Wim Van Criekinge, Manon van Engeland, Frans C.S. Ramaeke
Clinical Cancer Research.2013; 19(8): 2197. CrossRef
Altered expression of microRNA miR‐21, miR‐155, and let‐7a and their roles in pulmonary neuroendocrine tumors
Hyoun Wook Lee, Eun Hee Lee, Seung Yeon Ha, Chang Hun Lee, Hee Kyung Chang, Sunhee Chang, Kun Young Kwon, Il Seon Hwang, Mee Sook Roh, Jeong Wook Seo
Pathology International.2012; 62(9): 583. CrossRef
Differential expression of forkhead box M1 and its downstream cyclin‐dependent kinase inhibitors p27kip1 and p21waf1/cip1 in the diagnosis of pulmonary neuroendocrine tumours
Seung Yeon Ha, Chang Hun Lee, Hee Kyung Chang, Sunhee Chang, Kun Young Kwon, Eun Hee Lee, Mee Sook Roh, Boram Seo
Histopathology.2012; 60(5): 731. CrossRef

Primary Extrapulmonary Small Cell Carcinoma of the Appendix: A Case Report.: Jong Hyeok Park, Ki Jae Park, Young Hoon Roh, Mee Sook Roh; Korean J Pathol. 2010;44(1):101-105.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.1.101

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Abstract PDF: Primary extrapulmonary small cell carcinoma (EPSCC) of the appendix is an extremely rare entity, and there has been only one previous report on this in the English medical literature. We report here on the first Korean case of EPSCC of the appendix in a 55-year-old woman. The patient had no history of an identified pulmonary tumor, and she presented with constipation and lower abdominal pain. The patient underwent right hemicolectomy with regional lymph node dissection and bilateral salphigo-oophorectomy. The histology of the entire appendiceal tumor revealed pure EPSCC with diffuse immunoreactivity for pancytokeratin, cytokeratin 7, cytokeratin 20, CD56, thyroid transcription factor 1, c-kit and carcinoembryonic antigen, and there was focal weak immunoreactivity for chromogranin A and synaptophysin. After the second cycle of chemotherapy, the condition of the patient gradually deteriorated due to cancer peritonei and the patient died 7 months later. EPSCC of the appendix is a distinctive clinicopathological entity that displays highly aggressive behavior and an unfavorable outcome.

The Overexpression of Histone Deacetylase 1 and Its Relationship with p16INK4a Gene Hypermethylation in Pulmonary Squamous Cell Carcinoma and Adenocarcinoma.: Jong Hyeok Park, Young Seoub Hong, Phil Jo Choi, Na Young Kim, Kyung Eun Lee, Mee Sook Roh; Korean J Pathol. 2009;43(2):107-112.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.2.107

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Abstract PDF

BACKGROUND
DNA methylation and histone modification are dynamically linked in the epigenetic control of gene silencing and they play an important role in tumorigenesis.
METHODS
To evaluate the role of histone deacetylase 1 (HDAC1) in the development of lung cancer and the relationship between a HDAC1 overexpression and p16INK4a hypermethylation, we performed immunohistochemical staining for HDAC1 in 76 lung cancer specimens (39 squamous cell carcinomas and 37 adenocarcinomas) that had been previously evaluated for their p16INK4a methylation status by real-time quantitative polymerase chain reaction.
RESULTS
A HDAC1 overexpression (>50% of HDAC1 immunoreactive cells) was detected in 65 (85.5%) out of the 76 cases and it was more frequently seen in the squamous cell carcinomas (97.4%) than in the adenocarcinomas (73.0%) (p=0.002). The incidence of HDAC1 overexpression tended to be higher in the heavy smokers with more than 20 pack-years (p=0.067). Although there was no statistical significance, the frequency of p16INK4a hypermethylation in the cases with a HDAC1 overexpression (27.7%) tended to be higher than that in the cases without a HDAC1 overexpression (9.0%) (p=0.175).
CONCLUSIONS
A HDAC1 overexpression might be involved in lung carcinogenesis, and especially in a subgroup of smoking and squamous cell carcinoma patients, and a HDAC1 overexpression may be associated with p16INK4a hypermethylation.

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Deciphering the Mysterious Relationship between the Cross-Pathogenetic Mechanisms of Neurodegenerative and Oncological Diseases
Yulia Aleksandrova, Margarita Neganova
International Journal of Molecular Sciences.2023; 24(19): 14766. CrossRef
Microbiome dysbiosis and epigenetic modulations in lung cancer: From pathogenesis to therapy
Faizan Haider Khan, Basharat Ahmad Bhat, Bashir Ahmad Sheikh, Lubna Tariq, Roshan Padmanabhan, Jay Prakash Verma, Amritesh Chandra Shukla, Afshin Dowlati, Ata Abbas
Seminars in Cancer Biology.2022; 86: 732. CrossRef
Histone deacetylase HDAC1 expression correlates with the progression and prognosis of lung cancer
Lin-Lin Cao, Xiaoxu Song, Lin Pei, Lianhua Liu, Hui Wang, Mei Jia
Medicine.2017; 96(31): e7663. CrossRef
The synthesis and evaluation of N1-(4-(2-[18F]-fluoroethyl)phenyl)-N8-hydroxyoctanediamide ([18F]-FESAHA), A PET radiotracer designed for the delineation of histone deacetylase expression in cancer
Brian M. Zeglis, NagaVaraKishore Pillarsetty, Vadim Divilov, Ronald A. Blasberg, Jason S. Lewis
Nuclear Medicine and Biology.2011; 38(5): 683. CrossRef

p53, Heat Shock Protein 70 and Topoisomerase II Expression in Gallbladder Carcinoma.: Dae Cheol Kim, Mee Sook Roh, Jin Sook Jeong; Korean J Pathol. 2006;40(6):432-438.

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Abstract PDF: BACKGROUND
The present study was designed to investigate the expression of p53, Heat Shock Protein 70 (HSP70), and Topoisomerase (Topo) II alpha in the preneoplastic lesions and carcinomas of the gallbladder (GB) and to assess the correlation between the expression of these proteins and the clinicopathologic parameters by performing immunohistochemistry.
METHODS
The immunohistochemical expressions of p53, HSP70 and Topo II alpha were evaluated in 38 gallbladder carcinomas and 3 adenomas. Fifteen CIS(s) and 8 dysplasias that were located adjacent to invasive carcinomas were also studied.
RESULTS
A p53 expression was identified in 22 (57.9%) of the 38 GB carcinomas, in 9 (64.3%) of 14 CISs, and in none of the 8 dysplasias and 3 adenomas. A HSP70 expression was found in 11 (29%) of the 38 carcinomas, in 11 (78.6%) of 14 CIS(s), and in 4 (57.2%) of 7 dysplasias. A Topo II alpha expression was present in 36 (94.7%) of the 38 carcinomas, in 13 (92.9%) of 14 CIS(s), in 7 (100%) of 7 dysplasias and in 3 (100%) of 3 adenomas. p53 overexpression was related to the T stage of the primary tumor, while HSP70 and Topo II alpha were not related to any of the clinicopathologic parameters.
CONCLUSION
p53 may be involved in GB carcinogenesis and in the progression of cancer. p53 may be also helpful for making the differential diagnosis between dysplasia and CIS. A further large study is needed to better elucidate the roles of HSP70 and Topo II alpha in GB carcinogenesis.

Immunohistochemical Expression of the Sodium/Iodide Symporter in Patients with Primary Lung Cancer.: Hyoun Wook Lee, Do Young Kang, Phil Jo Choi, Doo Kyung Yang, Ki Nam Kim, Kyung Eun Lee, Mee Sook Roh; Korean J Pathol. 2006;40(2):81-85.

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Abstract PDF: BACKGROUND
The sodium/iodide symporter (NIS) is a membrane glycoprotein that facilitates the uptake of iodine by thyroid follicular cells. Although the use of radioiodide is essential for the diagnosis and treatment of thyroid diseases, few studies have been conducted to investigate the use of NIS-mediated radioiodide accumulation in lung cancer. We evaluated the expression of NIS by immunohistochemistry in order to examine the diagnostic or therapeutic feasibility of using radioiodide in the treatment of primary lung cancer.
METHODS
Immunohistochemistry for NIS was performed in 139 lung cancers. The expression pattern of NIS was compared with the clinicopathological characteristics of the tumors.
RESULTS
NIS immunoreactivity was detected in 75 (54.0%) of the 139 cases. Twenty-three (37.7%) of the 61 squamous cell carcinomas, 49 (76.6%) of the 64 adenocarcinomas, 2 (40.0%) of the 5 small cell carcinomas, and 3 (33.3%) of the 9 other carcinomas showed positive NIS immunoreactivity. The expression of NIS was significantly associated with the histologic type (p<0.001), but it did not correlate with tumor size, lymphovascular invasion or lymph node metastasis.
CONCLUSIONS
The presence of NIS was detected in lung cancer tissue using immunohistochemistry. Lung cancer potentially could be targeted with radioiodide for both diagnosis and treatment, especially in cases of adenocarcinoma.

Peripheral Micronodular Squamous Cell Carcinoma of the Lung Unexpectedly Discovered after an Operation for Spontaneous Pneumothorax: A Case Report.: Hyoun Wook Lee, Phil Jo Choi, Mee Sook Roh; Korean J Pathol. 2005;39(6):424-427.

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Abstract PDF: The occurrence of lung cancer in patients suffering with pneumothorax is very rare, especially in the absence of any radiological changes that would suggest neoplasia after the pulmonary reexpansion. We have experienced a case of a 60-year-old male who presented with lung cancer that was discovered by chance after an operation for his pneumothorax. The resected lung tissue showed a 0.3 cm-sized, peripheral squamous cell carcinoma associated with a bulla. The tumor was not macroscopically detected on the first thoracotomy that was performed for the treatment of the pneumothorax. The micronodular cancer was diagnosed after the histological examination of the resected bulla. The patient has been doing well with no evidence of tumor recurrence during the fifteen months follow-up. This case shows that we should always be vigilant for associated lung cancer when we examine the lung tissue after the operation for pneumotherax.

Differential Expression of CD34 and Smooth Muscle Actin in the Stroma of Small Lung Adenocarcinoma with Mixed Bronchioloalveolar and Invasive Components.: Mee Sook Roh, Jong Woo Choi, Hyoun Wook Lee, Hyuk Chan Kwon, Tae Ho Park, Phil Jo Choi, Chang Hun Lee, Bong Kwon Cheon; Korean J Pathol. 2005;39(3):158-163.

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Abstract PDF: BACKGROUND
Absence of CD34-positive fibroblasts was reported within the stroma associated with invasive carcinomas. Conversely, tumor-associated desmoplastic stroma is characterized by the presence of smooth muscle actin (SMA)-reactive myofibroblasts. The present study was undertaken in order to elucidate whether the different distributions of stromal CD34-positive fibroblasts and SMA-reactive myofibroblasts are sensitive or specific markers of tumor invasion in small lung adenocarcinomas.
METHODS
Immunohistochemical stainings for CD34 and SMA were done in 37 peripheral adenocarcinomas less than 3.0 cm in diameter, including 16 adenocarcinomas with bronchioloalveolar carcinoma (BAC) and invasive components (mixed), and 21 invasive adenocarcinomas without BAC components (invasive).
RESULTS
The fibroblasts within the BAC components of the mixed group were mainly CD34-positive (81.2%) and preferentially SMA-negative (56.3%). In contrast, the fibroblasts within the invasive components of the mixed group were mainly CD34-negative (75.0%) and SMApositive (87.5%). The stromal cells of the invasive group were mostly negative for CD34 (90.5%) and positive for SMA (95.3%).
CONCLUSIONS
The loss of CD34 and the acquisition of SMA in the stromal cells within the tumor were related to tumor invasion (p<0.05). Thus, expression patterns of CD34 and SMA can be used to detect small foci of early stromal invasion in adenocarcinomas of the lung.

Diffuse Leiomyomatosis of the Uterus: A Brief Case Report.: Su Jin Kim, Mee Sook Roh; Korean J Pathol. 2005;39(1):63-65.

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Abstract PDF: Diffuse leiomyomatosis of the uterus is a rare condition that is distinguished from the uterine leiomyoma due to the diffuse involvement of the myometrium by numerous, ill-defined, smooth muscle nodules. We present here a case of diffuse uterine leiomyomatosis in a 34-year-old woman. The hysterectomy revealed a symmetrically enlarged uterus containing numerous, small, ill-defined leiomyomatous nodules. Microscopically, the nodules were composed of compact fascicles and interweaving bundles of uniform benign smooth muscle cells. On the immunohistochemical staining, the progesterone receptor level was higher in the leiomyomatosis than in the adjacent normal myometrial tissue, but the estrogen receptor level and Ki-67 labeling index were equal in both areas. At the twelve months follow-up, this patient has been doing very well with no evidence of pelvic or intraabdominal recurrence of disease.

Angioleiomyoma of the Nasal Cavity: A Case Report.: Su Jin Kim, Sook Hee Hong, Mee Sook Roh; Korean J Pathol. 2004;38(3):181-183.

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Abstract PDF: Angioleiomyoma of the sinonasal area is an extremely rare benign neoplasm. To the best of our knowledge, only 26 cases have been described. Here, we report a case of angioleiomyoma arising in the nasal cavity of a 60-year-old woman. Microscopically, the tumor consisted of proliferating smooth muscle cells punctuated with thick-walled vessels with slit-like lumina. The tumor was negative for estrogen and progesterone receptor by immunohistochemical study. Further studies are needed to clarify whether the growth of this tumor is sex steroid-dependent.

Significance of Circumferential Resection Margin Involvement Following Esophagectomy for Esophageal Cancer.: Mee Sook Roh, Jae Ik Lee, Phil Jo Choi; Korean J Pathol. 2004;38(1):23-28.

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Abstract PDF: BACKGROUND
This study was performed to examine the significance of the circumferential resection margin (CRM) involvement by a tumor on the postoperative survival after esophageal cancer surgery.
METHODS
Fifty nine resected cases of esophageal cancers were retrospectively reviewed. The presence of a tumor either at, or within 1 mm of, the CRM was recorded. By an immunohistochemical study for Ki-67, the Ki-67 differential grades (Ki-67 DG) were defined according to the differences between the Ki-67 labeling indices of the central and of peripheral areas of the tumor nearest to the CRM: Ki-67 DG 0 (< or =10%) and Ki-67 DG 1 (>10%). The CRM involvement was correlated with the clinicopathological factors, Ki-67 DG and survival data.
RESULTS
CRM involvement was found in 26 (44.1%) of the 59 cases. There were significant differences in the cases, both with and without CRM involvement of tumor cells, in relation to lymph node metastasis, lymphovascular, perineural invasions and tumor stage (p<0.05). Ten (38.3%) of the 26 with, and 3 (9.1%) of 33 cases without, CRM involvement, showed Ki-67 DG 1 (p=0.007). The 3-year survivals of patients with and without CRM involvement were 26.8 and 61.8%, respectively (p=0.003).
CONCLUSIONS
These results show that the CRM involvement status may be used as a predictor of survival after esophageal cancer surgery, and CRM involvement is more an indicator of an advanced disease than of an incomplete resection.

Loss of PTEN Expression in Primary Lung Cancer.: Mee Sook Roh; Korean J Pathol. 2002;36(5):286-291.

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Abstract PDF: BACKGROUND
The phosphatase and tensin homolog deleted on chromosome 10 (PTEN) gene, a candidate tumor suppressor, is localized to chromosome 10q23 and shares extensive homology with cytoskeletal proteins auxilin and tensin. It appears to have multifunctional roles involved in cell proliferation, migration, and invasion. The role of PTEN alteration in the lung cancer and its relationship with other suppressor genes are not well established.
METHODS
Formalin-fixed, paraffin-embedded tissues from 105 patients with diagnosed with primary lung cancer were evaluated for PTEN and p53 protein expression using immunohistochemical methods. The results of the expression pattern of PTEN were compared with clinicopathological parameters and the expression pattern of p53.
RESULTS
Forty-seven (44.8%) of 105 cases had loss of PTEN expression. Loss of PTEN expression was significantly associated with histologic type (p<0.05), but did not correlate with tumor size, lymph node metastasis, and stage. There was no significant relationship between loss of PTEN expression and p53 expression, and no significant difference in clinicopathologic characteristics between particular groups of patterns with the four possible tumor carrying PTEN/p53 phenotypes.
CONCLUSION
It is suggested that loss of PTEN expression occurs commonly in primary lung cancers and correlates with histologic type. Our results also support the proposed role of PTEN as a candidate tumor suppressor in lung cancer, and we suggest that there is a need for further study of this gene.

Expression of pRb, p16, Cyclin D1 and Cyclin E in Infiltrating Duct Carcinoma of the Breast.: Hea Kyoung Hur, Mee Sook Roh, Jin Sook Jeong, Seo Hee Rha, Gi Yeong Huh, Sook Hee Hong; Korean J Pathol. 2001;35(5):416-423.

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Abstract PDF: BACKGROUND
Inactivation of the retinoblastoma protein (pRb) is a mechanism by which tumor cells can subdue normal growth control. Among the molecules involved in control of pRb phosphorylation, cyclin D1 and cyclin E have been found to be deregulated and overexpressed in various types of cancers.
METHODS
Immunohistochemical stains for pRb, p16, cyclin D1 and cyclin E were performed in 73 cases of infiltrating duct carcinomas of the breast. In addition to analysis of their expression rates, the relationships between their expressions and the clinicopathologic parameters were evaluated.
RESULTS
pRb, p16, cyclin D1 and cyclin E were positive in 64.7% (44 out of 68 cases), 24.6% (15 out of 61 cases), 43.8% (32 out of 73 cases) and 61.6% (45 out of 73 cases), respectively. Their expression rates were not significantly associated with clinicopathologic prognostic factors. 33 out of 38 cases with p16-negative reactions were pRb positive, while 10 out of 15 cases with pRb-negative reactions were p16 positive. There was a significant inverse relationship between pRb and p16 expressions (P<0.005). 25 out of 32 cases with cyclin E-positive reactions were cyclin D1-positive, and 25 out of 45 cases with cyclin D1-positive reactions were cyclin E-positive. A statistically significant association was observed between cyclin D1 and cyclin E expressions (P<0.05).
CONCLUSIONS
The main mechanism during tumorigenesis of breast carcinoma depends on the cyclin D1/p16/pRb pathway, but cyclin E might play a role in the absence of cyclin D1. The inverse correlation between the pRb and p16 expressions may represent one of the important mechanisms in tumorigenesis, as well.

Primary Carcinosarcoma of the Skin.: Mee Sook Roh, Gi Yeong Huh, Sook Hee Hong; Korean J Pathol. 2001;35(5):444-446.

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Abstract PDF: Carcinosarcoma is a biphasic tumor composed of intimately admixed malignant epithelial and mesenchymal components. Primary cutaneous cases are extremely rare; there are with only 18 cases documented in English literature to date. We present a case of a 55-year-old woman with a primary carcinosarcoma of the scalp. Histologically, the lesion consisted of an undifferentiated spindle cell sarcomatous component admixed with a resembling malignant tumor with eccrine differentiation. Immunohistochemistry showed the epithelial component to express cytokeratin and EMA and lack of vimentin expression. In the sarcomatous component, the staining pattern demonstrated the reverse. The patient received adjuvant radiotherapy; but one month later a recurring nodule developed at this site, and two months later, metastasis to the neck lymph node developed. There is no evidence of recurrence or metastasis after 25 months of follow-up.

Imprint Cytologic Feature of Pleuropulmonary Blastoma: A Case Report .: Mee Sook Roh, Ji Young Seo, Gi Yeong Huh, Pill Jo Choi, Sook Hee Hong, Jin Sook Jeong; Korean J Cytopathol. 2001;12(1):39-43.

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Abstract PDF: Pleuropulmonary blastoma (PPB) is an unusual intrathoracic blastoma presenting in childhood and characterized by a biphasic neoplastic population of undifferentiated, small round blastemal cells and larger spindle-shaped sarcomatous cells with entrapped benign epithelial-lined structures. We experienced the cytologic features of PPB in imprint smear from the pleural-based huge mass of the middle lobe of the right lung in a 4-year-old boy. The smears showed high cellularity composed of small ovoid blastemal elements and scattered spindle mesenchymal tumor cells. Lobectomy and pathologic investigation confirmed the diagnosis. PPB seems to be a tumor in which accurate diagnosis may be achieved by cytology if appropriate clinical information were given. Timely and accurate diagnosis of PPB by cytology paves the way for attempting preoperative treatment in future cases.

Rosai-Dorfman Disease of the Nose and Salivary Gland: A case report.: Mee Sook Roh, Jin Sook Jeong, Sook Hee Hong; Korean J Pathol. 1999;33(12):1203-1206.

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Abstract PDF: Rosai-Dorfman disease (RDD) is a rare type of benign histiocytosis characterized histologically by intracellular engulfment of lymphocytes. Extranodal RDD may occur as a part of generalized process involving lymph nodes or may involve extranodal sites independent of the lymph node status. We have experienced a case of extranodal Rosai-Dorfman disease of the nose as an initial lesion prior to nodal involvement. The patient was a 20-year-old woman who complained of nasal obstruction for 4 years, remotely, and left submandibular mass for 3 months, recently. Histologically, the lesion taken from nasal cavity, submandibular gland and left upper jugular lymph node all showed an heavy infiltrate consisted of plasma cells, lymphocytes and sheets of macrophages with abundant pale cytoplasm, which replaced organ architecture. The associated focal fibrosis made it difficult to differentiate from inflammatory pseudotumor. Some macrophages demonstrated phagocytosis of lymphocytes, plasma cells and occasionally neutrophils. The macrophages were strongly positive for S-100 protein.

Expression of E-cadherin and p53 Proteins in Gastric Adenocarcinoma.: Sook Hee Hong, Mee Sook Roh; Korean J Pathol. 1999;33(2):80-87.

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Abstract: The gastric carcinoma shows various molecular and genetic alterations in its development and progression. There are evidences that the changes of the expression of cell adhesion molecules affect the morphogenesis of the tumor as well as the tumor progression and metastasis. The purpose of this study is the evaluation of the expression pattern of a cell adhesion molecule, E-cadherin, and a tumor suppression gene, p53, by immunohistochemical stain and the relationship of their expressions with clinicopathologic findings in gastric adenocarcinoma tissue. The E-cadherin expression was absent or reduced in 93 cases (73.2%) and p53 was positive in 98 cases (77.2%) of 127 gastric adenocarcinomas. The frequency of reduced E-cadherin expression was significantly higher in poorly differentiated adenocarcinomas (p=0.04) and in diffuse type (p=0.01), but that of p53 positivity was not significantly correlated with tumor differentiation. Both proteins showed no correlation with depth of invasion, lymph node and distant metastasis, and tumor stage. There was no correlation between E-cadherin and p53 expression. This study indicates that the altered expressions of E-cadherin and p53 are associated with the development of intestinal and diffuse types of gastric adenocarcinoma and the differentiation of the gastric adenocarcinoma is affected by cell adhesion mediated by E-cadherin, but the modes of tumor progression and metastasis are not affected by E-cadherin and p53.

Alterations of the Mucin Glycoprotein Expression and Their Relationship with the Pathologic Prognostic Factors in Gastric Carcinoma.: Mee Sook Roh, Gi Yeong Huh, Sook Hee Hong; Korean J Pathol. 1999;33(1):15-24.

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Abstract: Alterations of the mucin-type glycoproteins may contribute to changes in cancer cell growth regulation, immune regulation, and cellular adhesion, which in turn may influence the invasive and metastatic capabilities of the cancer. Many of the cancer-associated antigens such as mucin antigens have been identified recently and alterations in the glycosylation of the mucins have been described in the cancer. Immunohistochemical studies of 3 antigens associated with alteration of the mucin glycoprotein (MUC1, MUC2, STn) were done to evaluate their relationship with known pathologic prognostic factors and their usefulness in assessment of the progression of gastric carcinoma in 127 gastric carcinoma tissues. The MUC1 was detected in 57 (44.9%), MUC2 in 76 (59.8%) and STn antigen in 77 (60.6%) out of 127 cases of gastric carcinomas. The expression rate of MUC1 was significantly correlated with depth of tumor invasion, lymph node and distant metastases, and advanced tumor stage (p=0.001). The expression rate of MUC2 was not significantly correlated with pathologic findings and known prognostic factors. The STn antigen was significantly associated with incidence of lymph node metastasis (p=0.02). The coexpression of both MUC1 and MUC2 or MUC1 and STn was more frequent in tumors with deep invasion, lymph node metastasis and advanced tumor stage than one or none expression (p<0.05). These results suggest that the alterations of expression of the mucin proteins, especially MUC1 and carbohydrate antigen (STn) are associated with poor biological behavior of the gastric carcinoma.

Angiomyofibroblastoma of the Vulva: A case report.: Mee Sook Roh, Hea Kyoung Hur, Sook Hee Hong, Sang Kap Kim, Young Cheol Baek, Hwa Sook Moon; Korean J Pathol. 1996;30(4):344-346.

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Abstract PDF: Angiomyofibroblastoma is a distinctive, hitherto uncharacterized, benign soft tissue tumor of the vulva with histology similar to an aggressive pelvic angiomyxoma. It can be distinguished from an aggressive angiomyxoma by its circumscribed borders, higher cellularity, more numerous blood vessels, the frequent presence of plump stromal cells, minimal stromal mucin, and rarity of erythrocyte extravasation. We experienced a case of angiomyofibroblastoma of the vulva occurring in a 45-year-old woman. The lesion was a well-defined but not encapsulated mass, 4.5x4.2 cm. Histologically the mass was characterized by alternating hypercellular and hypocellular edematous zones in which abundant blood vessels were irregularly distributed. Immunohistochemically, the spindled, plump spindled, and oval stromal cells were reactive for vimentin and desmin, but not for cytokeratin, or S-100 protein.

Expression Patterns of Bcl-2 and PCNA in Cervical Intraepithelial Neoplasia.: Mee Sook Roh, Gi Yeung Huh, Sook Hee Hong; Korean J Pathol. 1995;29(6):703-713.

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Abstract PDF: Immunohistochemical stains for bcl-2 oncoprotein and PCNA and examination of the mitosis level were perfon-ned in 76 cases of cervical intraepithelial neoplasia (CIN). We studied the expression pattern of bcl-2 protein according to histologic grades and the function of bcl-2 oncogene associated with cellular proliferation by comparing with PCNA expression and the mitosis level. The results were as follows: 1) Of 76 cervical intraepithelial neoplasias, 23 (30.3%) were CIN I, 23 (30.3%) were CIN II, and 30 (39.4%) were CIN III. 2) Of 23 CIN I cases, grade 0 and 1 mitosis level were seen in 20 (87.0%), PCNA in 16 (69.6%), and bcl-2 in 19 (82.6%) cases, respectively, which indicates that CIN I lesions have a low cellular proliferative activity. 3) Of 30 CIN III cases, grade 2 and 3 mitosis level were noted in 28 (93.3%), PCNA in 25 (83.3%) and bcl-2 in 19 (63.3%) cases, respectively, which indicates that CIN III lesions have a high cellular proliferative activity. The results suggest that progressive increase of dysfunctional proliferative activity and abnormal decrease of cell death result in increased number of neoplastic cells according to CIN grade. Also the expression rate of bcl-2, PCNA and mitosis level were significantly different between CIN I and 111, which suggest that they might be good parameters for classifying CIN into low and high grade and for prediction of the biologic behavior of the CIN lesion.

Elastofibromatous Lesion of the Stomach: A case report.: Mee Sook Roh, Sook Hee Hong; Korean J Pathol. 1995;29(1):103-105.

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Abstract PDF: Elastofibroma is a peculiar tumor-like lesion which manifests as a slowly growing, solid, ill-defined mass of fibroelastic tissue occurring almost exclusively in elderly persons. It has been found in the ,,ubscapular region but rare examples have also been found in other locations. We experienced a case of elastofibromatous lesion of the stomach. The lesion was incidentally found in a 71 -year-old woman during an operation of cholecystectomy due to chronic cholecystitis and choledocholithiasis. The lesion was a relatively well-defined but not encapsulated small nodule, 0.7 cm in diameter, at submucosal layer of gastric pylorus. Histologically the nodular mass consisted of abundant acellular collagen fibers containing numerous elastofibroma fibers.

Nesal T-cell Lymphoma associated with Hemophagocytic Syndrome: A case report.: Mee Sook Roh, Jin Sook Jeong, Sook Hee Hong; Korean J Pathol. 1994;28(5):541-543.

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Abstract PDF: Peripheral T-cell lymphoma is the generic group given to a family of tumors composed of neoplastic lymphocytes with phenotypic features of peripheral T-cells. Certain peripheral T-cell lymphomas develop a hemophagocytic syndrome that mimics malignant histiocytosis, both clinically and pathologically. We experienced a case of nasal T-cell lymphoma, histologically mimicking malignant histiocytosis in a 40-year-old male. The chief complaints were nasal obstruction and intermittent mild fever. Mild anemia, elevated SGOT and SGPT, polyclonal gammophthy, and moderate hepatomegaly were present. Two weeks later was present an enlarged cervical lymph node. The biopsied nasal mass showed angiocentric and angiodestructive peripheral T-cell lymphoma withextensive necrosis and marked erythrophagocytosis by non-neoplastic histiocytes. Subsequently, cervical lymph node was biopsied, which showed peripheral T-cell ltmphoma with extensive necrosis and erythrophagocytosis as well. The atypical lymphoid cells revealed pan-T(+), but CD4(-) and CD8(-), whereas the reactive histiocytes showed lysozyme(+), immunohistochemistry.

PCNA Labelling index and AgNORs of Transitional Cell Carcinoma of the Urinary Bladder.: Byung Gon Park, Sang Yong Lee, Mee Sook Roh, Seo Hee Rha, Sook Hee Hong; Korean J Pathol. 1994;28(5):469-477.

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Abstract PDF: Proliferating cell nuclear antigen (PCNA, PC10), an auxillary protein of DNA polymerase, plays a main role in the early stage of DNA Synthesis and is synthesized from Gl phase to s phase of the cell cycle. Nucleolar organizer region (NORs) are DNA loops encoding RNA proteins(AgNORs). To evaluate correlation with PCNA labelling index (LI)and AgNORs according to histological grades and clinical stages of transitional cell carcinoma of the urinary bladder, the authors analysed 54 transitional cell carcinoma using immunohistochemical stain for PCNA and silver stain for AgNORs in paraffin sections. The comparison of PCNA (PC10) LI and clinical stage showed a significant correlation (p<0.05), where as PCNA (PC10) LI according to histologic grade showed no significant correlation. High grade tumors showed increase PCNA LI. Superficial tumors (Ta-Tl) showed significantly lower PCNA LI than muscle invasive tumors (T2-T4)(p<0.05). There was no significant correlation between AgNORs and clinical stage, bur higher stage and higher grade tumors showed increased noubers of AgNORs. These results suggest that PCNA LI has a significant correlation with clinical stages of transitional cell carcinoma of the urinary bladder.

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