Journal of Pathology and Translational Medicine

Woo Ho Kim

42 Articles

Mucinous Tubular and Spindle Cell Carcinoma of the Kidney: Touch Imprint Cytologic and Histologic Findings: A Case Report.: Woo Ho Kim, Yong Il Kim, Seong Hoe Park, Jae Gahb Park; Korean J Cytopathol. 2008;19(2):194-199.; DOI: https://doi.org/10.3338/kjc.2008.19.2.194

1,846 View
14 Download
1 Crossref

The recent WHO classification has recognized mucinous tubular and spindle cell carcinoma (MTSCC) as a distinct entity of renal cell carcinoma, exhibiting a mixed pattern of tubules and a surrounding spindle cell proliferation within a myxoid stroma, with low-grade nuclear features. A 51-year-old woman had an incidentally discovered renal mass. Radiologic examination revealed a large, well defined mass in the lower pole of the right kidney; a right radical nephrectomy was performed. Imprint cytologic smears from fresh surgical specimens showed cellular, cohesive clusters with thick, broad trabecular arrangements and branching structures. On high power fields, the tumor was composed of round-to-oval low-grade nuclei with vesicular chromatin and small nucleoli. The tumor cells had indistinct borders and pale, eosinophilic cytoplasm. In some areas, round-to-elongated tubular structures and spindle cell patterns were noted. Chronic inflammatory cell infiltration was noted, along with a mucinous background and occasional psammoma bodies. Neither significant cytologic atypia nor mitosis was seen.

Citations

Citations to this article as recorded by

Mucinous Tubular and Spindle Cell Carcinoma of the Kidney with Aggressive Behavior: An Unusual Renal Epithelial Neoplasm - A Case Report -
Ji-Hye Lee, Mee-Hye Oh, Hyun Deuk Cho, Young-Sik Kim
The Korean Journal of Pathology.2010; 44(2): 211. CrossRef

Immunohistochemical Characteristics of Kaposi Sarcoma and its Mimicries.: Kyoung Bun Lee, Hye Seung Lee, Hee Eun Lee, So Yeon Park, Jin Haeng Chung, Gheeyoung Choe, Woo Ho Kim, Kye Yong Song; Korean J Pathol. 2006;40(5):361-367.

2,099 View
20 Download

Abstract PDF: BACKGROUND
The differential diagnosis of Kaposi sarcoma includes many disease that range from benign disease to malignant tumors. However, little information is available about the immunohistochemical characteristics of Kaposi sarcoma.
METHODS
The expressions of 13 various proteins (HHV-8 LNA-1, Ki-67, bcl-2, p53, CD31, CD34, factor VIII, D2-40, vimentin, SMA, S-100, EMA, and c-kit) were evaluated immunohistochemically in 49 vascular tumors including 16 Kaposi sarcomas, 8 angiosarcomas, 2 hemangioendotheliomas, and 23 benign vascular tumors with using the tissue array method.
RESULTS
All 16 cases of Kaposi sarcoma showed nuclear staining for HHV-8 LNA-1, whereas all the cases of angiosarcoma and benign vascular lesions were negative for HHV-8 LNA-1 (p<0.001). All Kaposi sarcoma were positive for D2-40, which is a marker of lymphatic differentiation, but 25% of the benign vascular lesions and 30.4% of the angiosarcoma were positive for D2-40 (p<0.001). The mean proliferation index as assessed by Ki-67 immunostaining revealed no difference between the benign and malignant vascular lesions (p>0.05). No Kaposi sarcoma showed a bcl-2 expression, but 62.5% of the angiosarcomas and 21.7% of the benign vascular tumors had bcl-2 expressions (p=0.005).
CONCLUSIONS
Immunohistochemical detection of HHV-8 LNA-1 and D2-40 are useful tools to differentiate Kaposi sarcoma from other vascular tumors.

A Standardized Pathology Report for Colorectal Cancer.: Hee Jin Chang, Cheol Keun Park, Woo Ho Kim, Young Bae Kim, Youn Wha Kim, Ho Guen Kim, Han Ik Bae, Kyu Sang Song, Mee Soo Chang, Hee Kyung Chang, Yang Seok Chae; Korean J Pathol. 2006;40(3):193-203.

2,223 View
137 Download

Abstract PDF: BACKGROUND
AND METHODS: For standardizing the pathology report and diagnosis of colorectal cancers, the Gastrointestinal Pathology Study Group of the Korean Society of Pathologists has developed a pathology reporting format for colorectal cancer in collaboration with the Korean Society of Coloproctology.
RESULTS
The diagnostic parameters are divided into two parts: the standard part and the optional part. The standard part contains most of the items listed in the Japanese classification, the TNM classification by AJCC, and the WHO classification. We included detailed descriptions on each item.
CONCLUSIONS
The standardized pathology report for colorectal cancers is adequate for its application to routine surgical pathology reports, and it is also helpful to decrease the discrepancies that occur during the pathologic diagnosis of colorectal cancer. Furthermore, this reporting format could encourage nationwide multi-center collaborative studies.

The Loss of Expression of Caveolin-1 in Gastrointestinal Stromal Tumors.: Eo Jin Kim, Jin Hee Sohn, Min Kyung Kim, Seoung Wan Chae, Hye Seung Lee, Eun Yoon Cho, Woo Ho Kim; Korean J Pathol. 2005;39(5):338-344.

1,859 View
18 Download

Abstract PDF: BACKGROUND
The down-regulation of caveolin-1, a putative tumor suppressor gene, has been demonstrated in several types of sarcomas. However, it's not known whether or not the gastrointestinal stromal tumors (GISTs) express caveolin-1. We carried out this study to investigate the caveolin-1 expression in GISTs and to determine the correlation between the clinicopathologic profiles of GISTs and the expression of caveolin-1.
METHODS
One hundred eight cases of formalin-fixed and paraffin-embedded tissues of GISTs were immunohistochemically evaluated for the expression of caveolin-1 by using the tissue-array method. Survival data of 98 cases of primary GISTs was analysed according to the expression status of caveolin-1.
RESULTS
Ninety three cases (86.1%) of 108 GISTs did not express caveolin-1 protein. There was no correlation between the caveolin-1 expression status and any of the clinicopathologic variables, including mitosis (p=0.948) and tumor grade (p=0.334). The expression of caveolin-1 was not correlated with other immunohistochemical marker proteins including, c-kit (p=0.373), CD34 (p=0.437) and SMA (p=0.831). On the univariate analysis, the caveolin-1 expression status (p=0.635) was not a significant predictor of the disease-free survival for GIST patients.
CONCLUSIONS
The results of this study suggest that caveolin-1 might act as a tumor suppressor gene in the GIST oncogenesis, but it has no function as a prognostic marker for disease free survival.

A Standardized Pathology Report for Gastric Cancer.: Woo Ho Kim, Cheol Keun Park, Young Bae Kim, Youn Wha Kim, Ho Guen Kim, Han Ik Bae, Kyu Sang Song, Hee Kyung Chang, Hee Jin Chang, Yang Seok Chae; Korean J Pathol. 2005;39(2):106-113.

3,858 View
312 Download

Abstract PDF: BACKGROUND
AND METHODS: The Gastrointestinal Pathology Study Group of the Korean Society of Pathologists developed a standardized pathology reporting format for gastric cancer in collaboration with the Korean Gastric Cancer Association. RESULTS: The diagnostic parameters are divided into two part: the standard part and the optional part. The standard part contains most of the items listed in the Japanese classification, the TNM classification by UICC, the WHO classification, and the Korean Gastric Cancer Association classification. Therefore, the standard part is adequate for routine surgical pathology service. We included detailed descriptions on each item.
CONCLUSIONS
The authors anticipate that this standardization can improve the diagnostic accuracy and decrease the discrepancies that occur in the pathologic diagnosis of gastric cancer. Furthermore, the standard format can encourage large scale multi-institutional collaborative studies.

Microsatellite Instability and Mismatch Repair Protein (hMLH1, hMSH2) Expression in Intrahepatic Cholangiocarcinoma.: Yun Kyung Kang, Woo Ho Kim; Korean J Pathol. 2005;39(1):9-14.

2,079 View
39 Download

Abstract PDF: BACKGROUND
To clarify the role of the mismatch repair (MMR) system in the carcinogenesis of intrahepatic cholangiocarcinoma (ICC), we investigated the microsatellite instability (MSI) status and MMR protein expression in ICC.
METHODS
Thirty-six cases of ICCs were examined by microsatellite analysis for 55 markers that encompassed all of the chromosomal arms and BAT26. An immunohistochemical study for hMLH1 and hMSH2 was also performed.
RESULTS
Widespread MSI (MSI-H) accompanied with a loss of hMLH1 expression was found in one case (2.8%). This MSI-H case was an adenosquamous carcinoma showing intraductal tubulopapillary adenocarcinoma and invasive adenosquamous carcinoma component. Loss of hMLH1 was noted in both components while the frequency and shifted band patterns of MSI were not identical between the components. Another 10 ICCs (27.8%) revealed low level MSI with preserved MMR gene expression.
CONCLUSIONS
Our data suggested that a genetic defect in the MMR system and MSI is not a major pathway in the carcinogenesis of ICC.

Prevalence and Clinicopathologic Features of Mucinous Cystic Tumor and Intraductal Papillary Mucinous Tumor of Pancreas in Korea.: Jin Hee Sohn, Kyung Me Kim, Seoung Wan Chae, Woo Ho Kim, Woo Sung Moon, Young Nyun Park, Chul Gun Park, Eun sil Yu, Hee Kyung Jang, Hee Jin Jang, Jong Jae Jung, Jin Sook Jung, So Young Jin, Jong Sang Choi, Dae Young Kang; Korean J Pathol. 2003;37(4):270-278.

1,644 View
14 Download

Abstract PDF: BACKGROUND
Mucin producing cystic neoplasms, such as mucinous cystic tumor (MCT) and intraductal papillary mucinous tumor (IPMT) of the pancreas, are uncommon but become increasing in their incidences. The pathologic classification and biologic potential of these neoplasmsremain the subject of controversy.
METHODS
The Gastrointestinal Pathology Study Group of the Korean Society of Pathologists analyzed the clinicopathologic characteristics of 85 casesof MCT and 72 cases of IPMT and examined the expression patterns of p53, CEA and MUC1.
RESULTS
IPMT was located largely in the head, and showed connection with the main pancreatic duct (MPD, 68.1%), no ovarian-like stroma (0/72), and presence of intervening intratumoralnormal or atrophic parenchyma. On the other hand, MCT was located largely in thetail (73%), and showed common ovarian-like stroma (66/80), rare connection with the MPD(7/85) and no intervening pancreatic parenchyma. CEA and p53 immunoexpressions weresignificantly increased from adenoma through borderline to carcinoma, but MUC 1 was expressedonly in the invasive carcinoma among cases of MCT and IPMT.
CONCLUSIONS
The tumorlocation, ovarian-like stroma, connection with the MPD and intratumoral intervening nonneoplastictissue were helpful in the differential diagnosis between IPMT and MCT. CEA and p53expressions can be indicators of malignancy, while MUC 1 expression can indicate invasion.

Altered Expression of p53, p21WAF1, p16, Rb, Smad4 and c-erbB-2 in Resected Pancreatic Ductal Adenocarcinoma.: Yun Kyung Kang, Woo Ho Kim; Korean J Pathol. 2002;36(6):382-388.

1,396 View
17 Download

Abstract PDF: BACKGROUND
Our aim was to undertake a comprehensive analysis of the expression of key molecular markers in a series of pancreatic ductal adenocarcinomas and to determine their association with clinicopathologic variables.
METHODS
By using immunohistochemical staining, we examined the expressions of five tumor suppressor genes (p53, p21WAF1, p16, Rb, Smad4) and a growth factor receptor (c-erbB-2) in 52 surgically resected pancreatic ductal adenocarcinomas.
RESULTS
Abnormal nuclear overexpression of p53 was noted in 28/52 (53.8%) cases. Total loss of p21WAF1, p16, Rb, and Smad4 was detected in 15/52 (28.8%), 33/52 (63.5%), 4/52 (7.7%), and 26/52 (50%) cases, respectively. Overexpression of c-erbB-2 was noted in 21/52 (40.4%) cases. Forty-nine (94.2%) cases revealed aberration of at least one of the markers examined. There was a positive correlation between p53 and c-erbB-2 overexpression (p<0.05). Among the examined genes, overexpression of c-erbB-2 was found to have a positive relationship with the tumor stage (p<0.05). There was also a significant correlation between the histologic grade and the number of abnormally expressed genes per tumor (p<0.05).
CONCLUSION
Among the various tumor-associated proteins evaluated in this study, c-erbB-2 could have the most likely clinical implication.

Tissue Array Method for Large Scale Clinicopathologic Study.: Woo Ho Kim; Korean J Pathol. 2002;36(4):199-204.

1,530 View
11 Download

Abstract PDF: Tissue array consists of a slide containing hundreds or thousands of cases, making this method useful for rapid analysis of molecular markers in a large number of cases. The method significantly facilitates and accelerates the clinicopathologic analysis of cancer. To maximize the efficacy of the tissue array method in pathologic study, the pros and cons of this method should be understood. In this review, the history and a detailed method of tissue array production is described, emphasizing the advantage of the large core size (2.0 mm). Some methological points, including slide storage, microtoming, core size, reliability, and data analysis, are discussed.

Expression of Cytokeratin 7 and 20 According to The Anatomical Location of Colon Cancer and The Differential Diagnosis with Cholangiocarcinoma.: Yoon Kyung Jeon, Sun Lee, Byoung Kwon Kim, Woo Ho Kim, Gyeong Hoon Kang; Korean J Pathol. 2002;36(3):146-153.

2,218 View
48 Download

Abstract PDF: BACKGROUND
Colonic adenocarcinoma usually shows CK7 negativity and CK20 positivity, which helps to differentiate it from cholangiocarcinoma usually showing a reverse immunohistochemical profile. We immunohistochemically investigated the pattern of CK7 and 20 expressions according to the anatomical location of colon cancer to refine the usefulness of CK expression in differential diagnosis.
METHODS
Immunohistochemical staining was done on 90 cases of surgically resected colon cancers and 84 cases of cholangiocarcinomas.
RESULTS
When the cases of colon cancer were divided into CATD (from the cecum to the descending colon) (32), sigmoid (26), and rectum (32), the positivity of CK7 was 41%, 15% and 28%, respectively, and the negativity of CK20 was 25%, 0 and 9% (p=0.013), respectively. In sigmoid colon cancers, 22 cases (85%) exhibited CK7-/CK20+ immunophenotype. However, the percentage decreased to 63% in the rectum and 47% in CATD. The CK7+/CK20- immunophenotype was found only in cancers in the cecum and ascending colon. The expression of CK7 was related to histologic differentiation (p=0.017).
CONCLUSIONS
The aberrant expressions of CKs were frequent in cancers of the rectum and ascending colon which are located in the transition site from the anus and small bowel, respectively. If adenocarcinoma in the liver were CK7+/CK20+ or CK7-/CK20-, the possibility of metastatic adenocarcinoma from CATD and rectum should be considered.

Malignant Peripheral Nerve Sheath Tumor in Descending Colon: A Case Report.: Young S Park, Sung Jing Lim, Woo Ho Kim, Eui Keun Ham; Korean J Pathol. 2002;36(3):179-183.

1,608 View
16 Download

Abstract PDF: We report a unique case of malignant peripheral nerve sheath tumor (MPNST) of colon, not associated with neurofibromatosis or parasite infection. The tumor presented as an encircling mass in descending colon causing obstruction with nuberous metastatic lesions in a 43-year-old man. The tumor was largely composed of spindle cells which showed strong positivity for vimemtin, S-100 protein and Leu-7. The tumor often exhibited epithelioid feature where tumor cells were weakly positive for cytokeratin.

Multiple Pancreatic Islet Cell Tumors with Diverse Hormonal Expression in a Multiple Endocrine Neoplasia Type I Patient: A Case Report.: Jang Han Kim, Kuhn Uk Lee, Woo Ho Kim, Yong Il Kim; Korean J Pathol. 2002;36(3):184-186.

1,509 View
11 Download

Abstract PDF: Multiple endocrine neoplasia type I is characterized by multiple tumors, particularly in the parathyroid glands, the pituitary gland and the pancreatic islet. We observed multiple pancreatic islet cell tumors with diverse hormonal expression in a MEN-I patient. The patient suffered from protracted diarrhea and multiple gastrododuodenal ulcers for 10 years. In abdominal computed tomography, space occupying lesions were detected in the distal pancreas. Distal pancreatectomy was done. Three tumors that measured 2.0 X 1.0 cm (A), 1.0 X 1.0 cm (B), and 1.0 X 0.5 cm (C) were discovered. Microscopic examination revealed another tumor, 1.0 X 0.5 cm (D). Microadenomas, less than 0.5 cm, were also found throughout the pancreas. Immunohistochemical stainings for insulin, pancreatic polypeptide, gastrin, glucagon, somatostain, and chromogranin were performed. Tumor A was trabecular and acinar in form and showed weak cytoplasmic reactivity to insulin. Tumor B was a gyriform and a few cells showed cytoplasmic reactivity to pancreatic polypeptide. Tumor C was trabecular in form and showed cytoplasmic reactivity to chromogranin. Direct invasion and distant metastasis were not found.

Improved Technique of Digoxigenin Labeled RNA in situ Hybridization.: Suk Keun Lee, Yeon Sook Kim, In Sun Song, Sang Shin Lee, Young Jun Lee, Woo Ho Kim, Je Geun Chi; Korean J Pathol. 2001;35(2):98-110.

1,546 View
15 Download

Abstract PDF: BACKGROUND
A practical RNA in situ hybridization method using digoxigenin labeled RNA probes is described in order to evaluate the technical difficulties and problems in RNA in situ hybridization.
METHODS
The paraffin sections, routinely processed in the Pathology Laboratory, were tested for the possibility of RNA in situ hybridization instead of the RNase free paraffin sections, fixed in 4% paraformaldehyde and prepared using RNase protection procedures.
RESULTS
Most of the paraffin sections, fixed in 10% neutral formalin solution in fresh condition, showed relatively good reaction of RNA in situ hybridization, although the necrotic tissue and autopsy specimens showed poor reaction of RNA in situ hybridization. A refixation procedure using a 4% paraformaldehyde solution was evaluated for optimal expression of mRNA in the paraffin sections.
CONCLUSION
The treatment of 4% paraformaldehyde before the treatment of proteinase K showed better in situ hybridization than did the treatment of 4% paraformaldehyde after the treatment of proteinase K. Also a new Polymerase Chain Reaction (PCR)-based method of RNA probe production showed consistently good results.

Microsatellite Instability in Colorectal Carcinomas.: Hee Jeong Cha, Dong Kyun Woo, Sun Hee Kim, Yong ll Kim, Jae Gahb Park, Woo Ho Kim; Korean J Pathol. 2001;35(2):111-114.

1,691 View
12 Download

Abstract PDF: BACKGROUND
Microsatellite instability (MSI), which is caused by a deficient mismatch repair system, is seen in most of the hereditary non-polyposis colon cancers and a portion of sporadic colorectal cancers.
METHODS
Two hundreds forty-six consecutive sporadic colorectal cancer patients were analyzed for MSI using an ABI 377 automatic sequencer and fluorescent dye-labelled primers (BAT-25 and BAT-26).
RESULTS
The overall incidence of MSI in studied cases was 9.8% (24/246). This incidence is lower than most of the reported incidences in western countries. The incidence of MSI tumors in the proximal colon was 29.6%, while that of the distal colon was only 4.2% (p<0.001). MSI in sporadic colorectal cancers was more prevalent in poorly differentiated adenocarcinoma. In contrast to western countries, mucinous carcinoma did not show higher incidence of MSI.
CONCLUSION
The results suggest that MSI frequently occurs in cancers of the proximal colon and in tumors with poorly differentiated histology.

Does the Colorectal Cancer Among Koreans Share the Same Pathological Features by Geographical Distribution: A Nationwide Survey of Surgically Resected 1,676 Cancers from 1,602 Patients.: Mee Soo Chang, Jin Hee Sohn, Dae Young Kang, Gyeong Hoon Kang, Myung Sook Kim, Woo Ho Kim, Jong Hee Nam, Woo Sung Moon, Sun Hoo Park, Cheol Jeun Park, Ro hyun Sung, Young Lyun Oh, Eun Sook Chang, Hee Kyung Chang, Mee Yon Cho, Kyung Ja Cho, Yong Il Kim; Korean J Pathol. 2001;35(1):14-19.

1,667 View
14 Download

Abstract PDF: BACKGROUND
This nationwide survey was undertaken to characterize the general pathological features of colorectal cancer in Korea, and especially to elucidate the geographical characteristics by means of their anatomical distribution.
METHODS
We analysed 1,676 colorectal cancers (from 1,602 patients) surgically resected in 1998 at 15 institutions from nine geographical sites in Korea.
RESULTS
The topographic incidence of colorectal cancer in seven out of the total nine geographical sites, was the highest in the rectum (32-54%); and those from Wonju and Cheongju were in the sigmoid colon (28% for both). The right colon cancer incidence was 42% in Wonju and 36% in Cheongju, while it was 17-22% in the other areas. The cecal cancer incidences in Wonju and in Taegu were 7% and 8%, respectively, but 0-4% in the other areas. As for histology, moderately differentiated adenocarcinoma was the most frequent (46-84%), except for in Wonju and Chonju, where the most predominant type was well differentiated (63% and 52%, respectively).
CONCLUSION
The incidence of right colon cancer was higher in Wonju and Cheongju, than in the other geographical sites. The cecal predilection was prominent in Taegu and Wonju. The Elucidation of geographical differences in degree of differentiation for tubular adenocarcinoma seems to require further cumulative study with strict guidelines.

Heterotopic Enchondral Ossification in Metastatic Colonic Adenocarcinoma: A case report .: So Yeon Park, Yong Il Kim, Woo Ho Kim; Korean J Pathol. 2000;34(7):531-533.

1,489 View
10 Download

Abstract PDF: Calcification and ossification of colon cancer is frequently encountered, especially in the mucinous carcinoma. However, cartilage formation or enchondral ossification has rarely been described in human colon cancer. This report describes a case of a 59-year-old man with retroperitoneal metastasis of mucinous adenocarcinoma of colon, which showed a widespread heterotopic ossification through membranous or enchondral ossification. The ossification appeared in apposition to tumor cell nests and in the organized mucin pool. In our knowledge, this is the first case showing enchondral ossification in gastrointestinal carcinoma in Korea.

Melanosis Duodeni.: Sun Hoo Park, So Yeon Park, Yong Il Kim, Woo Ho Kim; Korean J Pathol. 1998;32(12):1089-1091.

2,108 View
11 Download

Abstract: Melanosis duodeni is an uncommon pathologic condition characterized by diffuse small black spots on the first and second portions of the duodenum. It occurs predominantly in elderly patients and is linked to chronic renal failure, use of antihypertensive drug and oral iron supplementation, and/or presence of gastric hemorrhage. We report a case of melanosis duodeni in a 60-year-old woman diagnosed with hypertension 20 years ago and chronic renal failure 6 years ago. She has taken antihypertensive drugs for many years. On endoscopy, speckled black pigmentation of duodenal mucosa was detected. Microscopically, this duodenal lesions showed numerous coarse pigments in macrophages confined within the lamina propria. By ultrastructural study, macrophages contained electron-dense granules admixed with lipofuscin-like material in residual bodies.

Plastination: An Improved Method for Preservation of Pathology Specimens.: Chong Woo Yoo, Min Ho Choo, Sa Sun Cho, Sang Kook Lee, Je Geun Chi, Woo Ho Kim; Korean J Pathol. 1998;32(7):531-534.

1,653 View
10 Download

Abstract: The gross tissue specimens are a valuable aid to the teaching of pathology and anatomy. However, traditional methods for storage and handling of them are discouragingly difficult and, recently, minimal surgical resections as well as preoperative interventions make it more difficult to have instructive gross specimens. Plastination is a process of tissue preservation by impregnation with silicone polymers or epoxy resins. The process in our study involves dehydration by cryosubstitution in aceton, defatting, forced impregnation of silicon polymer in a vacuum, curing and finishing. We submitted 40 surgically resected specimens to plastination. The resulting specimens are odorless, relatively dry, durable, life-like, non-hazardous, maintenance-free, and do not deteriorate with time. Plastinated specimens are a useful adjunct to the teaching of pathology, particularly suited for use in small groups, and appropriate method of tissue preservation. They are much preferred to wet preparation and conventional pots by both students and teachers owing to their accessibility, superior illustrative powers, and comparative ease of interpretation.

Gastrointestinal Polyposis in Koreans: A Nationwide Survey of Clinicopathologic Analysis of 112 Surgically Resected Cases.: Mee Soo Chang, Hoguen Kim, Woo Ho Kim, Chan Il Park, Eun Kyung Hong, Han Kyeom Kim, In Soo Suh, Byung Kee Kim, Ja June Jang, Woon Sub Han, Hyung Sik Shin, So Young Jin, Dae Young Kang, Yong Il Kim; Korean J Pathol. 1998;32(6):404-412.

1,771 View
11 Download

Abstract: Gastrointestinal polyposis (GIP) is a rare disease characterized by formation of the numerous polyps in the gastrointestinal tract and presenting several extraintestinal manifestations. Most of the diseases are transmitted in an autosomal dominant pattern. In Korea, the epidemiological study as well as the pathological analysis of the GIP is not well established. We therefore analysed 38 items of GIP using surgically resected specimens. The materials in this study were collected from the 12 institutions and case reports in Korean literature between 1980 and 1991. The clinicopathologic findings were reevaluated by several members of the study group for gastrointestinal pathology. The results are as follows: (1) A total of 112 cases were included in this study: 83 cases were collected from 12 institutions and 29 cases were collected from Korean literature. The cases were classified as familial adenomatous polyposis (FAP), 59 cases; Gardner's syndrome, 3 cases; juvenile polyposis, 12 cases; Peutz-Jeghers syndrome, 35 cases; multiple colonic adenomas, 3 cases. (2) Among 59 cases of FAP, the range of age at operation was 14 to 61 years, and a family history was positive in 25 cases. The number of polyps in colorectum was 100~8,000. Of the 37 cases in which the examination of polyp density was available, 16 cases (43%) showed the highest density in the rectum and the sigmoid colon. The carcinomatous change within polyp(s) was present in 18 cases (31%), and associated advanced single or multiple colonic carcinomas existed in 37 cases (63%). Twenty-six (45%) tumors out of total 58 carcinomas were in the rectum. Twenty-five patients were evaluated for the upper gastrointestinal lesions, and 11 patients (44%) had pathologic lesions; multiple fundic gland polyps in 3 cases (12%), gastric and duodenal adenomas in 2 cases (8%), gastric adenomas in 2 cases (8%), duodenal adenomas in 2 cases (8%), gastric carcinoma and adenoma in 1 case (4%), gastric carcinoma in 1 case (4%). (3) Among 3 cases of Gardner's syndrome, the range of age at operation was 25 to 31 years, a family history was identified in 2 cases. One case was associated with an advanced colonic carcinoma and carcinomatous change within polyp. Extra gastrointestinal lesions were sebaceous cyst, epidermal cyst, osteoma and desmoid tumor. (4) Among 12 juvenile polyposis, the range of age at operation was 8 to 51 years and 5 patients had a family history. The carcinomatous change within polyp was found in 2 cases (17%) and associated advanced colonic carcinoma was in 4 cases (33%). The associated different type of polyps was tubular adenomas in 9 cases (75%), hyperplastic polyps in 4 cases (33%) and villous adenomas in 2 cases (17%). (5) Among 35 Peutz-Jeghers syndrome, the range of age at first operation was 6 to 42 years, family history was positive in 11 cases. The carcinomatous change within polyp was found in 1 case (3%), and associated advanced colonic carcinoma in 1 case (3%). The epithelial misplacement was observed in 4 cases (11%), and tubular or villous adenomatous feature in 4 cases (11%). In summary, the most frequent GIP for the surgical resection in Korea is FAP and the FAP is associated with high incidence of coexisting advanced and intramucosal carcinomas. Hamartomatous polyposis syndromes, such as juvenile polyposis and Peutz-Jeghers syndrome are another frequent disease for the surgical resection and are also associated with an increased risk of cancer.

The Current Practice of the Autopsy Services and the Autopsy Records at the Seoul National University Hospital.: Jeong Wook Seo, Yoon Sung Lee, Je Geun Chi, Ghee Young Choe, Soong Deok Lee, Chong Jai Kim, In Ae Park, Woo Ho Kim, Ja June Jang, Chul Woo Kim, Seong Hoe Park, Jung Bin Lee, Hyun Soon Lee, Yong Il Kim, Eui Keun Ham, Sang Kook Lee; Korean J Pathol. 1998;32(6):453-459.

1,656 View
10 Download

Abstract: This study outlines the current status of the autopsy practice and the medical records for autopsies at the Department of Pathology, Seoul National University Hospital. Total number of autopsy cases from 1954 to 1995 was 3,131. Adults aged over 17 were 371 cases and children were 2,515 cases. The demographic data in 245 cases was not available. The number of adult autopsies and its proportion among total number of autopsies during 10-year periods decreased from 144 cases (40%) during the 10-year-period from 1956 to 52 cases (3%) during the 10-year-period from 1986. The number of children cases during the same period groups increased slightly from 210 cases (58%) to 393 cases (25%). But the number of fetal cases increased rapidly from 7 cases (2%) to 1,146 cases (72%). Among fetal autopsies the proportion of fetuses died earlier than 24 weeks of gestation increased and this figure exceeds that of fetuses that died later than 24 weeks of gestation from 1992. Forty percent of the cases were submitted from the clinical departments of the Seoul National University Hospital but the remainders were referred from 73 hospitals. Final autopsy diagnoses were analysed according to the Korean Standard Classification of Disease (KCD)-3 coding system and by searching key words for all cases. Common diagnoses as coded among cases from 1990 were P9, P0, P2, Q2 and Q0. Common diseases by key words for adult cases were liver disease, tuberculosis and pneumonia. Common diseases for children cases were pneumonia, hyaline membrane disease, meningitis and tuberculosis. Through this study we could show the importance of autopsy services for fetuses. We could also establish a regular registration system for autopsies at general hospitals.

Correlation between Helicobacter pylori Infection and Lymphoid Follicle Formation in Gastrectomy Specimens.: Won Ae Lee, Hye Sung Hahn, Woo Ho Kim, Yong Il Kim; Korean J Pathol. 1998;32(3):162-168.

1,569 View
10 Download

Abstract PDF: Histopathologic studies for Helicobacter pylori (H. pylori)-associated chronic gastritis have been mostly undertaken with endoscopic biopsy specimens, often leading to an inappropriate evaluation of the gastric mucosal alterations. The purpose of this paper was designed to investigate the actual prevalence of lymphoid follicle formation by H. pylori infection using the resected stomachs. A total of 16 fresh gastrectomy specimens bearing gastric carcinoma were examined under the quick and gentle procedure, with which H. pylori was detected in 12 cases (75%) and lymphoid follicles in 14 cases (87.5%), while the detection rate of H. pylori remained 56.3% in the control group which comprised the same 16 resected stomachs and were examined by routine tissue preparation procedure without any special care. There was a significant correlation between the presence of H. pylori and lymphoid follicle formation (p=0.05), but no correlation was found between the grades of H. pylori and lymphoid follicles. The topographical distribution of H. pylori or lymphoid follicles in antrum and body gave no statistical difference. Similarly, there was no correlation between H. pylori infection and intestinal metaplasia, activity of chronic gastritis or histologic types of accompanying adenocarcinoma. We conclude that studies of the gastric mucosal change by H. pylori infection using the gastrectomy specimens provide a useful information for analysis of lymphoid follicle formation which is a consistent morphological characteristic of H. pylori infection.

Cytomegalovirus Infection in Idiopathic Inflammatory Bowel Disease: Clinicopathologic Analysis of 6 Cases.: Won Ae Lee, Hye Sung Hahn, Woo Ho Kim, Yong Il Kim; Korean J Pathol. 1998;32(2):125-130.

1,676 View
11 Download

Abstract PDF: Cytomegalovirus (CMV) infection is an uncommon association with idiopathic inflammatory bowel disease (IBD) often leading to a variety of serious complications. A total of 41 resected cases of IBD were examined to elucidate the pathologic features of intestinal CMV infection which was assessed by histologic examination and confirmed by immunohistochemistry with CMV antibody. Six cases were positve for CMV antibody; five cases in 19 ulcerative colitis (UC, 26.3%) and one case in 22 Crohn's disease (CD, 4.5%). Of 7 cases of the steroid-treated UC group, five cases were superinfected with CMV (71.4%) but none in 12 cases of the steroid-untreated UC group. All of the five CMV-positive cases in UC showed deep ulceration and transmural inflammation, while none of 10 UC cases without above features were CMV positive. Fibrinoid necrosis and thrombi were found in 83.3% of the CMV infected group, while none in the CMV-negative group of UC cases (p=0.01). We conclude that IBD, particularly UC, is susceptible to the CMV infection when steroid hormone is administered, and that deep colonic ulceration, transmural inflammation and fibrinoid necrosis of vasculature may suggest superinfection of CMV in UC patients. It seems that deep colonic ulceration may be the consequence of an ischemic change following vascular luminal occlusion or vasculitis by CMV infection.

Grading System for Gastric Epithelial Proliferative Diseases Standardized Guidelines proposed by Korean Study Group for Pathology of Digestive Diseases.: Hoguen Kim, So Young Jin, Ja June Jang, Woo Ho Kim, Sang Yong Song, Kyu Rae Kim, Eun Sil Yu, Hyung Sik Shin, Han Kyeom Kim, Jin Hee Sohn, Eun Kyung Hong, Youn Wha Kim, Jin Sook Jeong, Chang Jin Kim, Shin Eun Choi, In Suh Park, Chan Il Park, Yong Il Kim; Korean J Pathol. 1997;31(5):389-400.

1,683 View
36 Download

Abstract PDF: The assessment of epithelial changes in gastric mucosal biopsies has been one of the major problems caused by inconsistencies in and disagreements about nomenclature and interpretation. To resolve these issues, members of the Study Group for Pathology of Digestive Diseases reviewed microslides of 50 gastric lesions showing varying degrees of mucosal abnormality and reached the following consensus; 1) the proliferating gastric epithelium can be divided into hyperplastic and neoplastic; 2) the term "dysplasia" is reserved for the microscopic epithelial changes that are unequivocally neoplastic; 3) Biopsy specimens can be categorized as regenerative(negative for dysplasia), indefinite(questionable dysplasia), positive(positive for dysplasia) and overt carcinoma; 4) The positive category can be divided into two subgroups, high grade dysplasia and low grade dysplasia. Criteria for each grade are presented and discussed. We offer these guidelines for establishing the correct diagnosis of the gastric mucosal biopsy specimens and for prospective studies.

Application of the Revised Case Matrix Format to Tutorial in Pathology Teaching: An Interim Approach toward Problem-Based Learning under Traditional Curricular Structure.: Yong Il Kim, Chong Jai Kim, Gee Young Kim, Chul Woo Kim, Woo Ho Kim, Ja June Jang, Je Geun Chi, Gyeong Hoon Kang, Myeong Cherl Kook, Jung Sun Kim, Tae Sook Kim, Gee Young Kwon, So Dug Lim; Korean J Pathol. 1996;30(8):570-661.

1,691 View
10 Download

Abstract: This paper describes a student-centered case study program concerning the tumor pathology course for first year students in medical school under the traditional curricular structure. A traditional, discipline-oriented, lecture-laboratory approach was partly modified by introducing a tutuorial session using a modified case matrix format during the laboratory hours without altering the general scheme of the existing system. Small group tutorial sessions were set with the development of learning objectives emphasizing clinicopathologic reasoning and early exposure to future practical presentation which was followed by the large class session; each tutorial was supplied with a short clinical history, gross kodachrome slides, and microslides. The session for problem identification was replaced by proving a series of instructor-designed questions for both pathology and interdisciplinary correlation during which pedagogical implication was stressed the most. Student's active participation, development of self learning skill and vigorous teaching-learning process among students, and motivation/relevance for forthcoming pathology study were among the benefits conferred by this modification. We conclude that this approach is an interim step to meet the advantages of problem-based learning even in a traditional curricular structure.

Expression of BrdU and C-Ha-ras in Experimentally Induced Enzyme Altered Foci of the Liver and Hepatocellular Carcinoma.: Myung Sook Kim, Woo Ho Kim, Yong Il Kim; Korean J Pathol. 1994;28(6):584-595.

1,518 View
11 Download

Abstract PDF: For sequential phenotypic changes including enzyme altered hepatocytic foci, hyperplastic nodules, hepatocellular adenomas and carcinomas were produced in Sprague-Dawley rats by Solt-Farber method (administration of diethylnitrosamine and acetylaminofluorene (AAF), and partial hepatectomy). The immunohistochemical expressions of glutathione S transferase P (GST-P) and bromodeoxyuridine (BrdU) were assessed for selective proliferative activity in the enzyme altered foci and the subsequently developed lesions by double immunohistochemical staining technique. Immunoreactive areas against GSTP gradually increase from early period of carciogenesis. BrdU labeling in such areas remained high during the first week. but decreased thereafter. BrdU labeling index remained low in the GSTP negative area throughout the experimental period. This suggests that cells in the enzyme altered foci keep away from the suppressor effect of AAF in contrast to the normal cells in which their growth are inhibited by AAF. BrdU labeling index remained very low in both hyperplastic nodule and adenoma which were prevalent during the mid-experimental period, but increase markedly in carcinoma. The long period of low BrdU labeling index seems to correspond to the "slowly growing step of persistent nodule" during hepatocarcinogenesis. The differentiation index, a ratio of S phase fraction between GSTP positive and negative areas, was low in adenoma-developing period and high in carcinoma-developing period. C-Ha-ras p21 was not expressed in foci of enzyme altered hepatocyte and hyperplasia, but highly positive in carcinoma. This indicates that the c-Ha-ras may involve the late step of hepatocarcinogenesis.

Gagtric Adenocarcinoma with Choriocarcinomatous and Hepatoid Differentiation: Report of a case.: Kyeong Cheon Jung, Woo Ho Kim, Yong Il Kim, Kook Jin Choe; Korean J Pathol. 1994;28(4):409-413.

1,558 View
11 Download

Abstract PDF: Association of the hepatoid and choriocarcinomatous components in adenocarcinoma of the stomach is extremely unusual and raises a possibility of new approach understand the histogenesis of gastric hepatoid adenocarcinoma. This paper describes a Borrmann type III adenocarcinoma of the stomach with both choriocarcinomatous and hepatoid components in composite tumor pattern in a 50-year-old man. Tubular arrangement of differentiated embryonalcarcinoma was encountered in choricarcinomatous and hepatoid areas, which showed strong immunoreactivity to beta-HCG and AFP, respectively. The findings suggest that gastric adenocarcinoma may have a potential of differentiation toward embryonal carcinoma. from which both choriocarcinoma and hepatoid variant of gastric adenocarcinoma may develop by retrodifferentiation.

Gastrointestinal Cytomegalovirus Infection: A clinicopathologic analysis of 8 cases.: Yun Kyung Kang, Sang Yong Song, Woo Ho Kim, Yong Il Kim; Korean J Pathol. 1994;28(1):22-29.

1,455 View
12 Download

Abstract PDF: We analysed 8 cases of gastrointestinal cytomegalovirus(CMV) infection including one autopsy, three surgically resected and four endoscopic biopsy cases. Involved sites were colon in four,stomach in three and small intestine in one. Three of them were associated with immu-nosuppressed condition but others had no clinical evidence of immune deficiency. Multiple aphthous mucosal ulceration was a common presentation, but one revealed a mucosal ulcer with segmental narrowing and thickening of wall. Microscopically, six showed cytomegalic inclusions in endothelial cells and fibroblasts, one in mucosal epithelial cells and the remaining one in both endothelial cells and mucosal epithelial cells. Immunohistochemical staining using monoclonal antibody against CMV confirmed postive result in seven cases. Serum IgM anti-CMV antibody was elevated in one case. We conclude that gastrointestinal CMV infection is currently not a rare condition and frequently associated with non-immunosuppressed condition, and thus a thorough histologic examination is required especially in the gastrointestinal ulcerative lesion. Once cytomegalic inclusion is suspected, immunohistochemical identification of CMV seems essential for specific diagnosis.

Squamous Metaplasia in Tubular Adenoma of Sigmoid Colon: A case report.: Soo Min Kang, Weon Seo Park, Woo Ho Kim, Yong Il Kim; Korean J Pathol. 1993;27(6):663-665.

3,289 View
149 Download

Abstract PDF: The occurrence of squamous metaplasia(morule) in colorectal mucosa and adenocarcinoma, althrough rare, has been well documented. In contrast, very little mention has been given to mature squamous cells seen in colorectal polyps or adenomas. A 42-year-old woman presented with a 2-month history of diarrhea and melena. Proctosigmoidoscopy revealed a 4 cm-sized polypoid tumor 20 cm above the anal verge. Colonoscopic biopsy showed tubular adenoma, and a segmental resection of sigmoid colon was done. Microscopically, the tumor was c classical tubular adenoma containing multiple solid nests of squamous cells scattered only in the neoplasm; the squamous nests were generally small, and some showed direct continuity with adenomatous glands. The squamous cells were keratinizing and had regular nuclei with no mitotic activity. The importance of this phenomenon lies in its pathologic recognition, and the findings suggest that awareness of this rare occurrence in colorectal polyps should avert such overdiagnosis, and consequently prevents unnecessary radical surgery.

Gastroduodenal Adenomas and Carcinoma in Patients with Familial Polyposis Coli.: Seung Sook Lee, Woo Ho Kim, Yong Il Kim; Korean J Pathol. 1993;27(3):263-267.

1,489 View
19 Download

Abstract PDF: Gastric lesion in familial polyposis coli is commonly presented with fundic gland hyperplastic polyps, but duodenal and gastric adenomas together with their carcinomatous transformation have been rarely described in familial polyposis coli mostly by case reports. We present three cases of gastric adenomas in familial polyposis coli with one in synchronous development of gastric adenocarcinoma in Korea. All three cases had the family history related to familial polyosis coli and received proctocolectomy because of synchronous development of colonic adenocarcinoma. One patient developed gastric polyposis and adenocarcinoma 8 years after colectomy, and the remaining two presented with multiple polyps either in the stomach or duodenum synchronously at the time of the diagnosis of familial polyposis coli with colonic adenocarcinoma. None disclosed any evidence of Gardner's syndrome. We conclude that association of gastric adenomas in familial oplyposis coli is not uncommon and gastric adenoma-carcinoma sequence is an another important participating mechanism to understand the histogenesis of gastric carcinoma in Korea.

Pathological Analysis of 15 Cases of Phyllodes Tumors of the Breast.: Sung Nam Kim, Woo Ho Kim, Sang Kook Lee; Korean J Pathol. 1993;27(1):19-26.

1,629 View
12 Download

Abstract PDF: Retrospective clinicopathologic analysis of 15 patients with the phyllodes tumors(PT) of the breast, diagnosed at SNUH over 6 years period, was done. By light microscopy, 8 cases were diagnosed as benign, and 7 cases were diagnosed as malignant. Mean ages o the patients were 37 and 34 years in malignant and benign, respectively. Most of those cases were presented with a palpable mass of the breast. None of the patients with malignant PT had distant metastasis, Local recurrences were experienced in 3 patients among the malignant PT, and one patient among the benign PT. One of 7 malignant PT was coexisted with simultaneous ipsilateral infiltrating duct carcinoma. The clinical course was not well correlated with pathologic features. The prognostic significances of several histopathologic parameters were assessed for possible correlation with local recurrence, metastasis and death; stromal cellularity, stromal cellular atypism, mitotic activity, tumor contour, necrosis, tumor size and heterologous stromal elements. Immunohistochemistry using antibody to vimentin, proliferating cell nuclear antigen(PCNA) and epidermal growth factor receptor(EGF-R) were analysed. In the 5 cases of benign PT, the stromal cells stained diffusely positive for vimentin and 3 cases of malignant tumors show similar staining for vimentin. The percentage of PCNA-positive cells were higher in the malignant PT than in the benign ones; they were 3.5% to 60% in malignancy, while they were less than 60% in all benign PT. The results of EGF-R staining were correlated with the histologic classification; only 2 cases out of 8 benign PT show diffusely positive staining of EGF-R in the cytoplasm, but 6 cases out of 7 malignant PT show positive findings.

Gastric Metaplasia in Duodenum.: Young Lyun Oh, Mi Kyung Kim, Woo Ho Kim, Yong Il Kim; Korean J Pathol. 1992;26(3):242-246.

3,514 View
79 Download

Abstract PDF: The partial replacement of the human duodenal mucosa by epithelial cells containing gastric-type mucus(gastric metaplasia) is not an uncommon finding, and an emphasis on its etiological role in duodenal ulcerogenesis has been proposed. It is unclear, Furthermore, all the previous studies were done with endoscopic biopsy specimens. We reviewed a total of 118 surgically resected stomachs with attached duodenal stumps(24 cases of gastric ulcer, 15 duodenal ulcer and 79 advanced gastric cancer). The gastric-type mucous cells were homogeneously stained red with PAS in contrast to the intestinal cells which gave a strong PAS stainability only along the the brush border. The gastric metaplasia was seen near the tips or on the sides of the villi and occasionally in the crypts. It was observed in 8 cases(53%) in duodenal ulcer, 12 cases(50%) in gastric ulcer and 29 cases(37%) in gastric cancer. There were no significant statistical differences in incidence among the groups. Nevertheless, diffuse form of gastric metaplasia was more prevalent in patients with duodenal ulcer(p<0.05).

Combined Hepatocellular-Cholangiocarcinoma: Analysis of 8 cases with special reference to their growth patterns.: Yong Il Kim, Geun Kook Lee, Woo Ho Kim, Eun Sil Yu, Ghee Young Choe; Korean J Pathol. 1992;26(3):229-241.

1,526 View
12 Download

Abstract PDF: Eight cases of combine hepatocellular-cholangiocarcinoma(HCC-CC) of the liver were analysed along with their growth patterns and histologic subtypes to draw a possible implication in understanding of their histogenesis. The relative incidence of combined HCC-CC among the surgically resected primary carcinomas of the liver(485 cases) was 1.6%. The combination patterns varied and were classified as follows; the multinodular tumor, each consisting of HCC or CC element(type 1) was found in 1 case, the single tumor mass with two distinct compartments of HCC and CC(type 2) in 3, and the single tumor with random mixture of two elements(type 3) comprised the remaining 4 cases. Of the 7 cases of single tumor mass(type 2 and 3) HCC and CC comprised the major component in 5 and 2 cases, respectively. The histologic features of both HCC and CC elements were not different from those of isolated HCC and CC, except for two of CC element in type 3 which disclosed the intermediated differentiation or socalled cholangiolocellular carcinoma in part. We conclude that there is no significant difference in the relative incidence of combined HCC-CC among primary carcinomas of the liver and their subtypes compared to that in other countries, regardless of high incidence of both HCC and CC in Korea. Also, we discussed a possible histogenisis along a hypothesis that some of the combined HCC-CC be the consequence of interposition of different cell type from a new subclone into the growth of an initial single cell type of primary carcinoma of the liver.

Histologic Variations of Intramural Heterotopic Pancreas in Gastrointestinal Tract Analysis of 15 Cases.: Seung Sook Lee, Yong Il Kim, Woo Ho Kim, Eun Sil Yu; Korean J Pathol. 1991;25(6):520-527.

1,488 View
12 Download

Abstract PDF: We reviewed a total of 15 cases of heterotopic pancreatic tissue within the gastrointestinal wall(intramural type), and compared with 3 extramural ones. Intramural heterotopic pancreatic lesions were located in the antrum(33%), pylorus(20%), and body of stomach(7%), and the remainders in the duodenum(40%). Only two cases presented with chinical symptoms by their existence. Two of them were situated within the submucosa, 3 in the muscularis, 6 in submucosa-muscularis, 2 in the muscularis-subserosa, and 1 in the susbmucosa-subserosa. Intramural type was featured with their structural heterogeneity compared to the extramural ones; 10 cases showed participation of gastrointestinal mucosal elements, and some accompanied tissue elements that were indistinguishable from submucosal epithelial heterotopia or microduplication cyst of the stomach. Langerhans islets were found in 67%, and one developed islet cell tumor. The above results suggest that the initially engrafted heterotopic pancreatic tissue becomes modified and presents with heterogeneity of endodermal and mesodermal tissue-derived components by its intramural growth during the gastrointestinal organogenesis; failure of opening of its drainage system into the gastrointestinal lumen may result in the increase of intraductal pressure with subsequent atrophy of the acinar tissue and various metaplastic changes of ductal epithelium, aside from induction of smooth muscle coat around the heterotopic tissue.

Smooth Muscle Tumors of the Stomach : A clinicopathologic analysis of 46 cases.: Mee Soo Chagn, Yong Il Kim, Woo Ho Kim; Korean J Pathol. 1991;25(5):418-426.

1,705 View
10 Download

Abstract: This study was undertaken to characterize the clinicopathologic features of smooth muscle tumors of the stomach with additional regard to recent controversy over the gastrointestinal smooth mscle tumors. A total of 46 consecutive cases(47 tumors) of surgically resected or excised gastric smooth muscle tumors, were assessed for review. The criteria for malignancy applied in this study were one of the followings; (1) 5 or more mitoses/10 HPF or (2) 1-4 mitoses/10 HPF with tumor cell necrosis and 5 cm or greater in tumor size. The tumors were classified as ordinary leiomyoma in 24 cases(25 tumors), epithelioid leiomyoma in 3, cellular leiomyoma in 6, ordinary leiomyosarcoma in 10, myxoid leiomyosarcoma in 2, and epithelioid leiomyosarcoma in 1. Of the 46 cases, 13 cases(28%) were categorized as malignant smooth muscle tumor. But immunohistochemical study for S-100 protein, desmin and vimentin(5 cases), and ultrastructural study(2 cases) support that myogenic or neurogenic differentiation is evident simultaneously within the same tumor, regardless of malignancy, and that even the differentiated tumor cells seem to express such direction toward immature smooth muscle cell or nerve cell.

Mesenteric Cystic Lymphangioma with Sustained Abdominal Pain : Report of a case.: Gyeong Hoon Kang, Yong Il Kim, Woo Ho Kim, In Sung Song, Kyoo Wan Choi; Korean J Pathol. 1991;25(5):488-490.

1,462 View
11 Download

Abstract: A case of cystic lymphangioma of the mesentery with severe and persistent abdominal pain in a 22-year-old man is presented. The cyst was filled with chylous fluid. Microscopically, numerous nerve bundles were incorporated within the lymphangiomatous walls, and some protruded into the lumen. The above findings lead to a suggestion that mesenteric lymphangioma may differ from those in the other sites by its abundance of incorporation of nerve bundles into the lymphangiomatous walls, and that increase of tumor size by intracystic accumulation of chylous fluid may subsequently result in increase of intraluminal pressure to compress the nerve bundles with which abdominal pain is much enhanced.

Primary Linitis Plastica of the Rectum: A Clinico-Pathologic Analysis of Five Cases with Special Reference to Comparison with Gastric Form.: Mee Soo Chang, Yong Il Kim, Woo Ho Kim, In Ae Park; Korean J Pathol. 1991;25(2):114-122.

1,946 View
40 Download

Abstract PDF: Colorectal cancer can have a gross appearance similar to linitis plastica of the stomach. However, most of these cases are not primary colorectal lesions but are, indeed, metastases from other sites. This study was designed to answer the following questions; (1) Why is the linitis plastica of the large intestine so rare compared to that of te stomach? (2) Which part of the large intestine is predominantly affected by linitis plastical form? (3) Is the histogenesis of linitis plastica involving the lagre intestine similar to that involving the stomach? Of the 911 cases of the resected colorectal primary cancer, we found only 4 cases of primary linitis plastica of the intestine (0.4%) and another one case referred from other hospital. All involved the rectum; they were of encircling carcinoma with diffuse transmural infiltration of signet ring cell carcinoma accompanied by marked desmoplasia as in the gastric form. Signet ring cell carcinoma of the large intestine comprised 1.8%(n=16) of the total colorectal cancer(n=911), and predominantly occurred in the rectum(n=8). There was no histologic difference between the linitis plastica in both stomach and colon in terms of desmoplastic reaction, once the tumor infiltrated into the submucosa. We conclude that rarity of signet ring cell carcinoma in the large intestine together with its predominant occurrence in the rectum can explain low incidence of primary colorectal linitis plastica and high preference in the rectum.

Computerization of 100,000 cases of Surgical Pathology Data at SNUH by Automatic Coding System using Personal Computer.: Woo Ho Kim, Ghee Young Choe, Jeong Wook Seo, Yong Il Kim; Korean J Pathol. 1990;24(4):509-512.

1,488 View
17 Download

Abstract PDF: A computer program using automatic coding of the diagnosis has been used for report printing as well as data storage and retrieval system at the Department of Pathology, Seoul National University Hospital. Previous surgical pathology files were also computerized by the automatic coding system using personal computer, and 100,000 cases of surgical pathology data during 7 years were computerized at present. The cpmputerized surgical files were counted and listed according to topograph and morphologic diagnosis. It is available to print out the list of a specific diagnosis or to copy the records to a floppy diskette. Collection of cases in surgical pathology files using cpmputerized automatic coding system becomes much convenient and accurate than using stored file cards or log books. In addition, previous biopsy records of the patient are automatically searched during the routine work so that understanding of a patient as a whole is possible through the informations about previous pathologic diagnosis. We confirm that automatic coding methods is the most practical and economic method for computerization of the surgical pathology records.

Computerization of Surgical Pathology Reporting and Data Storage by Automatic Coding System using Personal Computer.: Woo Ho Kim, Jeong Wook Seo, Yong Il Kim; Korean J Pathol. 1989;23(4):410-415.

1,416 View
12 Download

Abstract PDF: The authors developed a computer program for use in report printing as well as data storage and retrieval system at the surgical pathology and its efficacy was evaluated at the Department of Pathology, Seoul National University Hospital. This program used IBM PC XT and was written in DBASE III plus language. The main features of the program included an automatic coding and decoding of the diagnosis, automatic searching of the previous biopsy during gross dictation, powerful word processing function and flexibility of the program. The data storage was carried out during the typewriting of the report, so that the typist's workload became markedly reduced. Two kinds of data files wer stored in the hard disk ; the temporary file contained full informations and the permanent file contained the core data only. Searching of a specific case was performed by pathology accession number, chart number, patient's name or by SNOMED code within a second. All the cases were arranged by copied to the diskette during the daily service automatically, with which data were easily restored in case of hard disk failure. The advantages of this program using a persosnal computer were discussed with comparison to those of larger computer system. Based on the experience of 8 months usage in Seoul National University, we assume that this program gives a sufficient solution to the surgical pathology service of many institutes where a large computer system with well designed software is not available yet.

Pedunculated Gallbladder Encircled by Accessory Liver: A case report.: Woo Ho Kim, Cheol Keun Park, Kyung Hyuck Ko; Korean J Pathol. 1987;21(4):274-277.

1,587 View
12 Download

Abstract PDF: The authors presented a case of gastroschisis with a pedunculated gallbladder embedded in hepatic tissue. The patient was born after fullterm gestation. Due to extensive abdominal wall defect, she succumbed 3 days after birth. There was a pedunculated mass measuring 2.5x1.5x1.5 cm between the liver and distended stomach without any attachment to the liver. The pedicle of the mass was connected to the common bile duct. Cut surface revealed that the mass was an accessory hepatic lobe encircling the gallbladder. The histologic feature of both accessory liver and gallbladder was markedly altered probably due to vascular obstruction. We could find only a single similar case in literlature. That case was associated with Beckwith syndrome and ours was associated with large atrial spetal defect, large patent ductus arteriosus, accessory spleen as well as gastroschisis. The common feature of abdominal wall defect might be a predisposing factor.

Immunohistopathologic Changes in Experimental Allergic Encephalomyelitis.: Woo Ho Kim, Je G Chi, Sang Kook Lee; Korean J Pathol. 1986;20(3):277-287.

1,367 View
10 Download

Abstract PDF: Experimental allergic encephalomyelitis (EAE) has been a well established animal model of postvaccinatal demyelinating diseases occurring in humans. Therefore elucidation of its pathogenesis would be very critical for the understanding of various human demyelinating diseases including multiple sclerosis. This study was performed to characterize the infiltrating cells in inflammatory sites and analyze the nature of the damage of blood brain barrier in experimental allergic encephalomyelitis. Experimental allergic encephalomyelitis was produced by administering homologous spinal cord homogenate together with complete Freund's adjuvant in guinea pigs. Immunostainings on guinea pig IgG, IgM, IgA and muramidase were performed by peroxidase-antiperoxidase or indirect immunofluorescent methods. The blood-brain barrier change was assessed by administering fluorescent Evans blue. Following results were made. In juvenile animals, both clinical findings and histopathologic changes were first noted by 3 weeks after injection and progressed during the whole experimental period. However, these findings were delayed in onset and low in incidence in adult animals. The clinical and pathologic changes started from the caudal portions and extended rostrally. The blood-brain barrier (BBB) was damaged and progressed starting also from the caudal portion of the spinal cord. The BBB changes were more severe in young animal than adult animals. Those changes preceded th histologic alterations. It is suggested that the BBB susceptibility is responsible for the caudal onset of histologic changes. Although the lesion has been thought to be induced by T-cell mediated hypersensitivity, infiltrating cells consisted mainly of muramidase positive histiocytes. A few immunoglobulin positive B cells or plasma cells could also be demonstrated in the lesion. The former usually infiltrated the parenchyme and the latter remained around the small or medium-sized vessels.

Primary Squamous Cell and Adenosquamous Carcinomas of the Stomach: Clinico-pathologic analysis of 6 cases.: Eun Hee Suh, Woo Ho Kim, Yong Il Kim; Korean J Pathol. 1986;20(1):60-70.

1,605 View
12 Download

Abstract PDF: Squamous cell carcinomas and adenosquamous carcinomas are rarely originated from the stomach, thus the limited and sporadic informations about their clinico-pathologic characteristics as well as histogenesis have been elucidated. Six cases of primary squamous cell carcinoma (3 cases) and adenosquamous carcinoma(3 cases) in the stomach were examined during a period of 4 years from 1981 to 1984. After pertinent review of both clinical data and morphology through extended histotopographic study performed on 4 cases, their clinicopathologic characteristics were described. Male to female sex ratio was 4 : 2 and average age was 58.6 years. Clinical presentations or physical findings were not different from those of adenocarcinoma. Tumor masses of all cases were located in the body or phloric antrum. In all cases except for the early gastric carcinoma, each tumor was larger than 8 cm in long axis, and showed expansile and intraluminal endophytic growing tendencies with sharp margin. Simple Borrmann's macroscopic classification was applicable to none of 6 cases because of irregular and multicentric ulceration pattern and occasional submucosal growth which were reminiscent of those in submucosal tumors such as malignant lymphoma and leiomyosarcoma. Virtually four out of all six cases were diagnosed as submucosal tumor at the time of radiological examination. Microscopically three cases were composed of pure squamous cell carcinoma and remaining three contained both adeno and squamous components. Metastatic regional lymph nodes revealed only squamous element in case of pure squamous cell carcinoam, while both components were identified in adenosquamous carcinomas. Surrounding non-tumors mucosa exhibited moderate to severe degree of intestinal metaplasia accompanied by multifocal mucin pool formation. Growth pattern and surrounding mucosal changes as with older age prevalence of these tumors might express the biological behavior of intestinal type of gastric carcinoma.

Metastatic Giant Cell Carcinoma of Thyroid Simulating Primary Small Intestinal Tumor: Report of a case with ultrastrucutral and immunohistochemical studies.: Woo Ho Kim, Yong Il Kim, Seong Hoe Park, Jae Gahb Park; Korean J Cytopathol. 1985;19(2):194-201.

1,290 View
16 Download

Abstract PDF: We present a case of metastatic giant cell carcinoma of the thyroid in small intestine presenting as an unusual polypoid growth, and its ultrastructure and immunohistochemical reaction to thyroglobulin were investigated. The patient was a 63 years old female who received a segmental resection of ileum for intestinal obstruction, one year after a radical neck dissection and thyroidectomy for anaplastic (giant cell variant) carcinoma with a focus of papillary tumor of the thyroid. In the segmentally resected ileum, there were three conglomerated round intraluminal polypoid tumor masses in close approximation which measured 4.5 cm, 2.5 cm and 2 cm respectively. The histological features were similar to those of thyroid lesion, being predominantly made of anaplastic giant and spindle cells in haphazard arrangement. Ultrastructure of pleomorphic spindle cells and multinucleated giant cells demonstrated numerous mitochondria with tubular cristae, rough endoplasmic reticula and a few membrane-bound dense granules. Peroxidase-antiperoxidase method against thyroglobulin revealed strong positive staining on papillary carcinoma and weak positivity on both giant cells and spindle cells of the anaplastic carcinoma. The above observations confirm that multinucleated giant cells of small intestine originate from metastatic giant cell carcinoma of the thyroid.

Author index