- Alveolar Soft Part Sarcoma of the Lung: A Report of Six Cases and Clinicopathological Analysis.
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Na Rae Kim, Mi Sook Lee, Young Cheol Yoon, Dae Su Kim, Kyong Soo Lee, Gee Young Suh, Jhingook Kim, Joung Ho Han
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Korean J Pathol. 2003;37(2):87-92.
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- BACKGROUND
Alveolar soft part sarcoma (ASPS) accounts for 0.5-1% of soft tissue sarcomas, and often metastasizes to the lung. Cases of pulmonary ASPS of unknown primary site have rarely been reported in literature.
METHODS
Here, we report three cases of metastatic pulmonary ASPS and three cases of presumably primary ASPS using immunohistochemistry and clinicoradiologic findings.
RESULTS
All of the cases occurred in young females. Two of the cases had metastasized from soft tissue ASPS of the lower extremities, and one case had metastasized from one of the patient? femur bones. Immunohistochemical stains were applied to four cases that had available paraffin blocks.
The tumor cells of all cases on which immunohistochemical stains were done were positive for vimentin (4/4, 100%).
None of the tumors were positive for myoglobin, desmin, smooth muscle actin, progesterone receptor, estrogen receptor, thyroid transcription factor-1, S-100 protein, pancytokeratin, and HMB-45 antibodies.
CONCLUSION
The present study revealed that the rare pulmonary ASPS has nonspecific clinicoradiologic findings.
In the immunohistochemical results, no differences existed between the presumably primary ASPS and the metastatic ASPS except for a higher Ki-67 labeling index in the latter (less than 0.1% vs. 30%). The higher index was not dissimilar to those of the extrapulmonary ASPS which showed a tumor with a low proliferation index, signifying a better prognosis and have a low potential to metastasize.
- Overexpression of p53 Protein in Endometrial Hyperplasia and Adenocarcinoma.
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Yun Sin Kim, Mi Sook Lee, Sung Chul Lim, Jang Shin Sohn, Chae Hong Suh
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Korean J Pathol. 1997;31(7):655-661.
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- Proliferations of the endometrial glands form a continuum from focal glandular crowding through simple hyperplasia, complex hyperplasia and atypical hyperplasia to frank adenocarcinoma. But objective criteria to distinguish these proliferative endometrial lesions are not clear-cut and terminology is confusing. The p53 protein is a nuclear phosphoprotein that can regulate cell proliferation and suppress tumor growth. Mutation in the p53 gene have been reported in a variety of human tumors, and in selected malignancies overexpression of p53 has been associated with poor prognosis. In this study we examined a series of endometrial proliferative lesion, including hyperplasia, adenocarcinoma, and adenomyosis to determine whether or not p53 is overexpressed in these lesions. In the result, p53 immunoreactivity was observed in 3 of 17 (17.6%) simple hyperplasia, one of 6 (16.6%) complex hyperplasia, none of 3 (O%) atypical hyperplasia, 6 of 13 (46.1%) adenocarcinoma and none of 10 (O%) adenomyosis. In conclusion, p53 mutation seems to play a role in oncogenesis of endometrial adenocarcinoma in early phase but there was no significant relationship between p53 overexpression and histologic grade of adenocarcinoma.
- Bilateral Elastofibroma: Report of a case.
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Sung Chul Lim, Mi Sook Lee, You Kyung Jeong, Yun Shin Kim, Hyun Jong Park, Mi Ja Lee
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Korean J Pathol. 1997;31(6):589-591.
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- Elastofibroma is a rare benign tumor-like condition manifesting as firm and spherical mass with poorly circumscribed margins of fibroelastic tissue, occuring in the subscapular region or the chest wall of elderly persons.
It is not a true neoplasm but rather a reactive or degenerative process causing abnormal elastogenesis. It is unilateral in the majority of cases and the right side is affected more commonly than the left. We report a case of bilateral elastofibromas removed from both subscapular regions of a 73-year-old female farmer. She was presented with tender masses on the bilateral subscapular areas for seven years. Microscopically, it consisted of a mixture of intertwining broad eosinophilic collagen bundles and elastic fibers associated with a few fibroblasts and mature fat cells. The elastic fibers had a degenerated beaded appearance or were fragmented into serrated globules in a linear arrangement.
- Benign Cystic Mesothelioma.
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Sung Chul Lim, You Kyung Jeong, Mi Sook Lee, Yun Shin Kim, Hyun Jong Park, Sang Joon Choi
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Korean J Pathol. 1997;31(6):595-597.
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- Benign cystic mesothelioma (BCM) is a rare mesothelial lesion that forms multicystic masses in the upper abdomen, pelvis and retroperitoneum. Although it is categorized as a benign lesion, it has a tendency to recur. It is uncertain whether the nature of this lesion is reactive or neoplastic, but many articles support the conclusion that it is reactive rather than neoplastic. The majority of cases were associated with a history of a previous abdominal or pelvic operation, or an evidence of endometriosis or a pelvic inflammatory disease, or a combination of these findings. In a 26-year-old woman we experienced a case of BCM which was incidentally discovered at cesarean delivery revealing multilocular thin and translucent walled cysts in the pelvic cavity. Microscopic examination revealed a thin cyst wall that was composed of fibrous connective tissue and lined by internal stratified and external nonstratified single cuboidal epithelia.
- Appendiceal Polyp: A report of two cases.
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Ki Hwa Yang, Jung Min Lee, Mi Sook Lee, Sang Ho Park, Young Gun Yoon, Choong Gu Kang
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Korean J Pathol. 1996;30(11):1045-1049.
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- Varying types of polyps could occur in the vermiform appendix. However, it is very unusual. Collins found 57 cases (0.08%) of benign mucosal polyps in the 71,000 cases of appendectomy specimens. There has been no reported case of appendiceal polyp in the literature in Korea. The authors experienced two cases of polyp in the vermiform appendix.
The first case was a 51 year-old male patient who received a left hemicolectomy due to colonic polyposis. The second case was a 71 year-old male patient who was treated by appendectomy under the clinical diagnosis of acute appendicitis. The microscopic type of both cases were hyperplastic polyp.
- Endothelial Cyst of the Adrenal Gland: Report of a case.
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Sung Chul Lim, Mi Sook Lee, Yun Sin Kim, Keun Hong Kee, Yu Kyung Jeong, Mi Ja Lee, Soon Bong Chung
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Korean J Pathol. 1996;30(8):742-745.
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- Adrenal cysts are rare lesion that usually present themselves as an incidental finding during surgery, or at the time of autopsy. The cysts are usually small, seldom exceeding 10cm in diameter, and are generally asymptomatic.
However, they present a difficult problem in differentiation between benign and malignant lesions of the adrenal gland.
In the differential diagnosis, other cystic lesions of the upper abdomen must also be considered, including hepatic, splenic, renal and pancreatic cysts. Herein we report a case of endothelial cyst of lymphangiomatous type of the adrenal gland which was detected in a 44-year-old male patient during a routine health examination by ultrasonography as a pancreatic pseudocyst. Gross examination revealed multiple separate but continuous cysts, measuring 10.6x8x7cm in dimension. Within the wall, compressed adrenal cortex was noted. Microscopically, fibrous wall containing hypertrophied smooth muscle lined by endothelial cells was also noted. We reviewed literatures of the adrenal cyst and report a case.
- p53 Expression in the Head and Neck Tumor.
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Chae Hong Suh, Mi Sook Lee, Sin Eui Yoon
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Korean J Pathol. 1996;30(7):576-586.
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- Mutations in the p53 gene seem to be the most common genetic changes in human malignancies. Mutation or altered p53 expression is a common occurrence in many solid neoplasms, including head and neck carcinomas. Recent studies have also shown p53 alterations in several premalignant conditions of the colon, esophagus, lung, and brain. Preliminary data have suggested that p53 mutations may be involved in tumor progression. This study was performed to determine the incidence of p53 mutations in histologically 27 squamous cell carcinomas, 19 basal cell carcinomas, 18 Schneiderian papillomas, 3 Schneiderian papillomas with malignant transformation, and 15 pleomorphic adenomas of the head and neck region. The degree of p53 gene overexpression was also evaluated according to differentiation, histologic type of tumor, and tumor progression in the head and neck carcinomas. The results were as follows; 1) Eighteen of 27 squamous cell carcinomas, and 4 of 27 dysplasias adjacent to the squamous cell carcinoma of the head and neck expressed p53 protein, but none of the normal control specimens expressed detectable p53 protein. There was no relationship between differentiation of squamous cell carcinoma and p53 protein expression. 2) Twelve of 19 basal cell carcinomas expressed p53 protein; the adenoid type especially overexpressed p53 protein. 3) Nine of 15 pleomorphic adenomas expressed p53 protein especially in the epithelial components. 4) Thirteen of 18 Schneiderian papillomas and all Schneiderian papillomas with malignant transformation expressed p53 protein. The above results indicate that the p53 protein expression is a useful tool for the prediction of tumor progression in the head and neck tumor, but there was no relationship between the differentiation of the tumor and p53 protein expression.
- Suprasellar Rathke Cleft Cyst: A case report.
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Mi Sook Lee, Yu Kyeong Jeong, Mi Ja Lee, Keun Hong Kee
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Korean J Pathol. 1996;30(7):649-651.
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- We report a case of a large asymptomatic Rathke cleft cyst in a 14-year-old boy. This cyst was of considerable size, measuring 2x1.8x1.8 cm, but did not produce any symptoms and was confined to the suprasellar area. The cyst wall was lined by pseudostratified ciliated columnar epithelium with goblet cells. The lining epithelium of the Rathke cleft cyst was immnoreactive for cytokeratin, EMA and CEA.
- Immunohistochemical Study of p53 Protein Expression in Colorectal Tumors.
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Mi Sook Lee, Chae Hong Suh, Sung Chul Lim
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Korean J Pathol. 1996;30(7):595-603.
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- The aims of this study were to assess the role of p53 overexpression in colorectal tumorigenesis and the association with clinicopathological features. The immunohistochemical results were semiquantitatively assessed. Expression of aberrant p53, tumor-suppressor gene product, was studied immunohistochemically using a monoclonal antibody in 11 nonneoplastic polyps, 19 tubular adenomas, 9 villous adenomas, and 48 colorectal carcinomas.
Five out of 11 nonneoplastic polyps, 14 out of 19 tubular adenomas and one out of 9 villous adenomas expressed p53 protein. Seven out of 24 colorectal carcinomas without lymph node metastasis and 14 out of 24 colorectal carcinomas with lymph node metastsis expressed p53 protein. The case of more than 75% positivity of p53 in colorectal carcinoma with lymph node metastasis was seven out of 24, but that in lymph node negative group was two out of 24. In the colorectal carcinoma with lymph node metastasis group; metastatic intranodal neoplastic cells were expressed positively for p53 in 10 out of 14 cases and zero out of 10 cases in group of positive and negative expression of primary lesions, respectively. p53 protein expression was not significantly correlated with variable clinicopathologic features such as age, sex, tumor location, tumor size, differentiation and Dukes' stage. It is suggested that p53 protein overexpression could be a early event in pathogenesis of colon cancer but is not involved in progression of villous adenoma to adenocarcinoma. p53 overexpression seems to be involved in metastatic ability of colorectal carcinomas.
- Paragonimiasis Involving the Female Genital Tract and Cul De Sac: A case report.
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Mi Sook Lee, Yun Sin Kim, Sung Chul Lim, Keun Hong Kee, Ho Jong Jeo, Chae Hong Suh
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Korean J Pathol. 1996;30(5):457-459.
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- Paragonimiasis caused by Paragonimus westermani is essentially a pulmonary disorder, but it is also known to cause ectopic parasitism at various sites in human host such as the brain, muscle, liver, spinal cord and spleen. Ectopic parasitism of the female genital tract, especially the ovary is relatively rare. We have experienced a case of a 62-year-old Korean woman with asymptomatic ectopic paragonimiasis in the salpinx , ovary, and cul de sac.
- An Immunohistochemical Study on the Expression of the Bauhinia Purpurea in the Reed-Sternberg Cells.
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Yun Sin Kim, Mi Sook Lee, Ho Jong Jeon, Bong Nam Choi, Jong Hoon Jung, Choon Hae Chung, Chul Woo Kim
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Korean J Pathol. 1995;29(4):459-468.
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- The diagnosis of Hodgkin's disease is based on the morphologic identification of Reed-Sternberg (RS) cells and its variants in paraffin-embedded sections. The origin of RS cells remains a subject of controversy, and cells resembling RS cells are observed in some non-Hodgkin's lymphoma of T-cell lineage. In this study, eighteen cases of Hodgkin's disease (3 nodular sclerosis, 6 diffuse lymphocyte predominance, and 9 mixed cellularity) were studied with peanut agglutinin(PNA), anti-Leu-M1(CD15), LN2(CD74), Ber-H2(CD30) and bauhinia purpurea (BPA) by the avidin-biotin-peroxidase complex(ABC) method in paraffin-embedded sections. RS cells and their variants revealed positive reactions with one or more of the reagents in all examined cases. BPA staining was positive in 17 of 18 cases (94.4%), PNA staining was positive in 9 of 18 cases (50.0%), Leu MI was positive in 7 of 18 cases(38.9%), Ber-H2 was positive in 11 of 18 cases (61.1%), and LN2 was positive in 8 of 18 cases(44.4%). The staining properties of examined markers were recognized as paranuclear, diffuse cytoplasmic and cellular membranous patterns, but LN2 disclosed diffuse cytoplasmic staining in the positive cells. BPA also showed dense cytoplasmic staining reaction with macrophage-histiocytes. BPA reactivity was not affected by fortnalin fixation or paraffm embedding. Thirty six cases of non-Hodgkin's lymphomas(IO T-cell and 26 B-cell type) were also examined. The neoplastic cells of those cases did not stain positive with BPA, PNA, and Leu-Mi, but stained positively with LN2 in 3 cases of T-cell lymphomas and 14 cases of B-cell lymphomas, and BeT-H2 in T-cell lymphomas.
In conclusion, to facilitate the detection of RS cells and related variants in paraffm sectionse of Hodgkin's disease, BPA can be used as a useful marker because of its high-detection rate, reproducible staining pattem, and resistance to fixative.
- Non-Hodgkin's Malignant Lymphoma Arising in the Appendix: A case report.
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Yun Sin Kim, Mi Sook Lee, Kwang Seok Lee Lee, Sung Chul Lim, Ho Jong Jeon
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Korean J Pathol. 1995;29(4):524-526.
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- Primary malignant lymphoma of the appendix is an unconnnon neoplasm although the gastrointestinal tract is the most common extranodal site of malignant lymphoma. We report a case of primary malignant lymphoma of the appendix in a 54-year-old male, who presented with pain in the right lower abdomen. An appendectomy was performed. The appendix measured 9.5 cm in length and 5.5 cm in diameter. Cut sections showed a solitary circumferential mass in the appendiceal lumen. Light microscopic features were compatible with malignant lymphoma of diffuse large cell type(Working Formulation) and the immunophenotype was B cell type.
- Effusion Cytology of Ki - 1 Positive Anaplastic Large Cell Lymphoma: A Case Report.
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Mi Sook Lee, Mi Ja Lee, Yu Kyung Jeong, Sung Chul Lim, Keun Hong Kee, Ho Jong Jeon
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Korean J Cytopathol. 1995;6(2):163-168.
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- Ki-1 positive anaplastic large cell lymphoma is a newly described high-grade lymphoma and is defined by histopathological and immunologic criteria. We experienced a case of systemically involving Ki-1 positive anaplastic large cell lymphoma in a 44 year-old female which initially manifested as pleural effusion. Abdominopelvic CT scan showed the evidence of marked lymphadenopathy in retroperitoneal and both external and inguinal lymph nodes.
On cytologic examination of pleural fluid tumor cells revealed pleomorphic large isolated cells with prominent nucleoli and abundant cytoplasms. The nuclei were large with irregular profiles including some deep invaginations. Also.
occasional multilobed/multinucleated and binucleated nuclei were seen. Immunohistochemical examination was performed to differentiate from the undifferentiated adenocarcinoma.
Hodgkin's disease, non-Hodgkin's lymphoma and malignant histiocytosis. The neoplastic cells were positive for leukocyte common antigen. CD3 CD30(ki-1) but negative for cytokeratin. epithelial membrane antigen. and CD15. A histologic diagnosis of Ki-1 positive anaplastic lymphoma was made by biopsies of the inguinal lymph node, polypoid lesion of the stomach and cecum.
- Immunocytochemical Characteristics of the Short-term cultured Mesothelial Cells.
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Ho Jong Jeon, Mi Ja Lee, Mi Sook Lee, Yu Kyung Jeong, Young Mi Lee, Hyung Ho Choi
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Korean J Cytopathol. 1995;6(2):106-115.
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- Reactive human mesothelial cells were examined by immunocytochemical stain with intermediate filaments(cytokeratin [CK1, CK7, CK8, CK18, CD19/, vimentin, desmin, actin), epithelial membrane antigen, carcinoembryonic antigen(CEA), MHC class II antigen(HLA-DR), LeuM-1(CD15), alpha1-antitrypsin(ACT), alpha1-antichymotrypsin (ACHT), CD68(KP-1) and FcgammaRIII(CD16). The mesothelial cells were isolated from patients with liver cirrhosis and pleural effusion, and short-term cultured in RPMI 1640 media containing 10% heat inactivated fetal calf serum and 1% identical supernatant fluid of the patients' transudates. The results obtained are as follows.
1. The cultured-reactive mesothelial cells were positive for the protein of cytoskeleton such as cytokeratin and vimentin, but negative for desmin and actin. The resting mesothelial cells showed positive reactions for cytokeratin, but negative for vimentin, desmin and actin.
2. The primary antibodies to the cytokeratin were strongly reactive for CK1, CK8 and CK18 but negative for CK7 and CK19 in both reactive and resting mesothelial cells.
3. Resting mesothelial cells showed negative reactions for CEA, but strong positive reactions in cultured-reactive mesothelial cells.
4. The markers for the monocytes\histiocytes (CD11b, CD14, CD16, CD68, lysozyme and alpha1-antitrypsin and alpha1-antichymotrypsin) were nonreactive in resting mesothelial cells, but lysozyme and alpha1-antitrypsin were weakly reactive in reactive and proliferative mesothelial cells.
5. MHC Class II molecule(HLA-DR antigen) was negative in both resting and reactive mesothelial cells.
These results suggest that the short-term cultured, reactive mesothelial cells show a newly aberrant expression of the vimentin and carcino-embryonic antigen. The reason of the aberrant expression of the intermediate filament and oncofetal antigen in reactive and proliferative mesothelial cells should be further evaluated.
- Cytology of Anaplastic Thyroid Carcinoma with Varied Histologic Patterns Arising in Preexisting Goiter: Report of A Cese.
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Mi Ja Lee, Mi Sook Lee, You Kyung Jeong, Sung Chul Lim, Keun Hong Kee, Ho Jong Jeon
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Korean J Cytopathol. 1995;6(2):187-192.
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- Anaplastic carcinoma of the thyroid(ACT0 is a rare subtype of thyroid neoplasm. This tumor represents approximately 5-10% of all thyroid malignancies and has poor prognosis.
ACT often arises in a long-standing thyroid nodule and has been documented to be associated with a variety of more with a variety of more well-differentiated thyroid carcinomas. We experienced a case of anaplastic thyroid carcinoma who had had about a year history of thyroid goiter. The patients had been injected with sclerosing agents in treatment of preexisting goiter. The ACT in this case had varied cytologic and histologic appearances pleomorphic, giant cells, spindle and squamoid. Immunohistochemically, strong cytoplasmic positivity for cytokeratin was seen in all kinds of tumor cells. Ultrastructurally. the evidences of epithelial differentiation were seen such as intercellular junctions and tonofibrils.
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