- Clinicopathologic Features of Granulomatous Mastitis.
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Yee Jeong Kim, Yoon Jung Choi, Ji Young Kim, Hee Jung Kim, Yang Soon Park, Soon Won Hong, Chanil Park, Doyil Kim, Hyde Lee, Woo Hee Jung
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Korean J Pathol. 2005;39(3):181-186.
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- BACKGROUND
Granulomatous mastitis (GM) is a rare chronic inflammatory condition that clinically mimics a carcinoma.
The diagnosis of idiopathic GM depends on the exclusion of other granulomatous inflammations. The purpose of this study is to correlate the clinicopathological features of GM with etiologies.
METHODS
We reviewed the clinical records of 58 cases that were histologically diagnosed as GM. We performed special stains for microorganisms such as Ziehl-Neelsen, periodic acid Schiff and gram stains, and polymerase chain reaction (PCR) for Mycobacterium tuberculosis (TB PCR).
RESULTS
The mean age of patients was 35.3 years. Most patients were parous except three. Seven patients (12.1%) were related with pregnancy or lactation. TB PCR was positive in nine patients (15.5%). Five patients (8.6%) had gram positive bacilli that were recognizable as coryneform bacteria. Culture study demonstrated Staphylococcus aureus in only one case. Infectious GM had a greater tendency to form abscesses. Fat necrosis was more likely to be present in idiopathic GM, but other histological features were similar to each other. Twenty-two cases (37.9%) showed recurrence.
CONCLUSIONS
We suggest that TB PCR and gram stain are essential tests for the differential diagnosis of GM, because the histologic features considerably overlap irrespective of the various etiologies.
- Usefulness of Frozen Section Examination of Core Needle Biopsy in the Breast Carcinoma.
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Yee Jeong Kim, Yi Kyeong Chun, Sung Ran Hong, Hy Sook Kim, Sung Su Kang, Ji Hyun Lee, Sung Kong Lee, Hye Sun Kim
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Korean J Pathol. 2002;36(3):163-166.
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- BACKGROUND
Core needle biopsy (CNB) is widely used as the initial sampling method for breast cancer. And because frozen section (FS) diagnosis is rapid and reliable, we studied the diagnostic agreement between the diagnosis of FS of CNB and final diagnosis after surgery to evaluate the diagnostic accuracy of the FS of CNB.
METHODS
Of 409 patients who were preoperatively diagnosed by FS of CNB and who underwent final surgery from 1996 through 2000, 24 cases were found to be ductal carcinoma in situ (DCIS) and 385 cases invasive carcinoma (IC). The diagnoses of FS of CNB were compared with final diagnoses.
RESULTS
The diagnostic accuracy of carcinoma is 63.6% for DCIS and 86.9% for invasive carcinoma. Five cases (1.2%) could not be diagnosed because of material insufficiency for diagnosis. Twenty two cases (5.4%) were diagnosed as benign on FS, among which 20 (90.9%) were misdiagnosed by sampling error. Twenty seven cases (6.7%) were deferred on FS, 4 of these cases were DCIS, 5 were invasive lobular carcinoma (ILC), the rest displayed low nuclear grades or marked freezing artifacts.
CONCLUSIONS
The diagnostic accuracy of FS of CNB is very high except for cases of ILC and low grade DCIS. Considering the advantage of rapid evaluation, more definitive diagnosis, familiarity by pathologists and availability of ancillary study, FS of CNB is very useful method as the preoperative evaluation.
- Placental Pathology in Intrauterine Growth Retardation.
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So Young Park, Moon Young Kim, Yee Jeong Kim, Yi Kyeong Chun, Hye Sun Kim, Hee Soo Kim, Sung Ran Hong
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Korean J Pathol. 2002;36(1):30-37.
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- BACKGROUND
Histologic examination of the placentas from intrauterine growth retardation (IUGR) fetuses can supplement clinical knowledge of the cause of IUGR. The present study was undertaken to observe the pathologic findings regarding the placentas in IUGR fetuses.
METHODS
Clinicopathologic findings in 45 cases with IUGR at the third-trimester were reviewed, and they were compared with those of 24 normal control cases. An IUGR fetus was defined as one with a birth weight less than those in the 10th percentile. Of the IUGR cases, 15 were hypertensive IUGR with or without preeclampsia, and 30 were normotensive IUGR.
RESULTS
The IUGR groups had significantly shorter mean gestational ages, lower mean placental weights, and higher incidences of oligohydramnios, compared to the normal controls (p<0.05). Histologically, IUGR was characterized by increased incidence of decidual vasculopathy (31.1%, p<0.05), multiple and severe infarct (p<0.05), villous fibrosis (31.1%, p<0.05), syncytiotrophoblastic knots (86.7%, p<0.05), and higher degree of increased perivillous fibrin deposition (p<0.05). However, there were no statistically significant differences in the placental lesions between hypertensive and normotensive IUGR cases, except for the presence of decidual vasculopathy.
CONCLUSIONS
Abnormal uteroplacental vasculature and chronic uteroplacental insufficiency, coagulation-related pathology in the uteroplacental, intervillous and/or fetoplacental vasculature, and chronic inflammatory lesions may be the primary disease processes related to the placental pathology of IUGR. Although the cause of IUGR pregnancies is heterogeneous, careful cilinicopathologic correlations in individual cases are necessary in the interpretation of placental lesions of IUGR, and the total burden of several placental lesions may be more important than a single histologic feature.
- Expression of p53 Protein and Ki-67 in Atypical Ductal Hyperplasia, Ductal Carcinoma in Situ, and Microinvasive Ductal Carcinoma of the Breast.
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Yi Kyeong Chun, Hye Sun Kim, Yee Jeong Kim, Sung Ran Hong, Hy Sook Kim, Byung Jun Park, Sung Su Kang, Ji Hyun Lee, Sung Kong Lee, Sun Hee Sung, Woon Sup Han
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Korean J Pathol. 2000;34(9):665-672.
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- Mutation of the p53 gene is one of the most common genetic alterations in invasive breast carcinoma. However, it is unclear that the mutation usually occurs in noninvasive breast lesions. It might be expected that there is a correlation between histologic progression of breast lesions and proliferative rate. We investigated the expression of p53 protein and Ki-67 labelling index (LI) using immunohistochemistry in 16 ductal carcinoma in situ with microinvasion (DCIS-Mi), 56 DCIS, 15 atypical ductal hyperplasia (ADH), and 7 intraductal hyperplasia (IDH).
Expression of p53 protein was detected in 33.9% of DCIS and 56.3% of DCIS-Mi and was confined exclusively in Van Nuys DCIS group 2 and 3. In ADH and IDH, no expression of p53 protein was found.
There was no significant correlation between Van Nuys DCIS groups and Ki-67 LI. In conclusion, p53 mutation may be involved in the neoplastic progression from ADH to DCIS and is directly related to high nuclear grade and associated necrosis of DCIS.
- Complete Hydatidiform Mole with a Coexisting Fetus: A case report .
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Yi Kyeong Chun, Hye Sun Kim, Yee Jeong Kim, Hy Sook Kim, Soo Kyung Choi, So Yeon Park, Sung Ran Hong
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Korean J Pathol. 2000;34(9):673-676.
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- Twin conceptus of a complete hydatidiform mole (CHM) and a normal fetus are rare but are important because of diagnostic difficulty, problems related to twin pregnancy, and high risk of persistent gestational trophoblastic tumor. Recently, we experienced one case of twin pregnancy consisting of a CHM and a normal fetus. A 26-year-old woman complained of vaginal bleeding. She had evidences of pregnancy-induced hypertension. A male fetus was delivered at 20 gestational weeks.
The placenta demonstrated vesicles of molar change separated from normal placenta.
Microscopically, the molar villi disclosed diffuse hydropic swelling with circumferential trophoblastic proliferation. DNA flow cytometric analysis showed diploid patterns in both molar and normal placental tissues. Fluorescent in situ hybridization in paraffin-embedded tissue presented that normal placental villi hybridized with X- and Y-chromosome probes (46, XY), while molar villi hybridized with X-chromosome only (46, XX). Thus, dizygotic twinning was confirmed because sex differences were shown between molar villi and normal placental villi. Follow up beta-hCG was within normal range after delivery.
- Cytologic Features of Endometrial Hyperplasia: Comparison with Normal Endometrium and Endometrial Adenocarcinoma.
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Sung Ran Hong, Mee Im Seon, Yee Jeong Kim, Yi Kyeong Chun, Hye Sun Kim, Hy Sook Kim
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Korean J Cytopathol. 2000;11(1):1-10.
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- The purpose of this study is to describe the cellular characteristics of endometrial hyperplasia without/with atypia in cervical smears. These cellular features were compared with those of normal endometrium and endometrial carcinoma. We reviewed 265 cervical smears : 64 normal proliferative endometrium, 118 endometrial hyperplasia without atypia, 21 endometrial hyperplasia with atypia, and 62 endometrial adenocarcinoma. Of these smears, 72(27.2%) smears which had diagnostic endometrial epithelial cells were selected for this study. The cytologic abnormalities about cellularity, background, changes in cellular architecture, alterations in nuclear size, anisokaryosis, chromatin pattern, nucleoli, cytoplasmic vacuoles, and mitosis were observed. Nuclear enlargement(1.6 to 2 times of the nucleus in the intermediate squamous cell) and anisokaryosis(> OR =2 fold in size variation) were highly suggestive of endometrial hyperplasia without/with atypia.
The nuclei from endometrial hyperplasia with atypia were more coarsely granular in chromatin patterns than hyperplasia without atypia(33.3% vs 3.4%). Micronucleoli were observed in all endometrial conditions, but the presence of macronucleoli were more suggestive of hyperplasia with atypia(22.2%) and adenocarcinoma(55%). The changes in cellular architecture(loss of polarity, uneven internuclear distance, overlapping and loose
- Ductal Carcinoma In Situ of the Breast: Comparison of Histologic Classifications and Correlation with Histologic Grade of Coexisting Invasive Ductal Carcinoma.
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Sung Ran Hong, Yee Jeong Kim, Yi Kyeong Chun, Hye Sun Kim, Hy Sook Kim
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Korean J Pathol. 1999;33(6):434-442.
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- Recently developed new classifications (Holland, Van Nuys, modified Lagios) of ductal carcinoma in situ (DCIS) linked to outcome have emphasized the importance of nuclear morphology rather than architecture. We have evaluated these three classifications in ductal carcinomas composed of in situ and invasive carcinomas. The reproducibility of three classifications was assessed (n=49), and the histological grade of the DCIS was compared with the histologic differentiation (modified Bloom & Richardson method) and nuclear grade (modified Black method) of the coexisting invasive ductal carcinoma (n=45). According to Holland classification, the DCIS component was poorly differentiated in 51.0%, intermediately differentiated in 40.8%, and well differentiated in 8.2%. Using the Van Nuys classification, the DCIS component was group 3 (high grade with or without necrosis) in 44.9%, group 2 (non-high grade with necrosis) in 28.6%, and group 1 (non-high grade without necrosis) in 26.5%.
According to the modified Lagios classification, the DCIS component was high-grade in 42.8%, intermediate-grade in 32.7%, and low-grade in 24.5%. The histologic grades of the three classifications revealed significant correlations between Holland and Van Nuys classification (p<0.0001) and between Holland and modified Lagios classification (p<0.0001), especially in poorly differentiated/group 3/high-grade DCIS. The reproducibility of classification of the DCIS was 71.4% in the Holland, 61.2% in the Van Nuys, and 55.1% in the modified Lagios classifications. The grade of the DCIS showed significant correlation with the grade of coexisting invasive ductal carcinoma (p<0.0001), especially in poorly differentiated/group 3/high-grade DCIS. In conclusion, DCIS grade, determined by the Holland, Van Nuys or modified Lagios classifications, is closely correlated with the histologic grade of the invasive ductal component in tumors composed of in situ and invasive ductal carcinoma, and may be a useful factor to estimate clinical behavior of DCIS. In our experience the Holland classification is recommended for DCIS classification due to its high reproducibility.
- Osteochondrodysplasia Pathologic study of 29 autopsy cases.
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Yi Kyeong Chun, Yee Jeong Kim, Sung Ran Hong, Min Suk Kim, Je G Chi
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Korean J Pathol. 1999;33(1):32-41.
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- Osteochondrodysplasia is a heterogeneous group of disorders appearing short limbed dwarfism. Because many of these entities are lethal and hereditary, an accurate diagnosis is mandatory. The purpose of this study is to define the clinicopathologic features and radiologic findings of osteochondrodysplasia. We reviewed 29 autopsy cases of congenital short limbed dwarfism, consisting of thanatophoric dysplasia (TD) (12 cases), osteogenesis imperfecta (OI) (12 cases), asphyxiating thoracic dysplasia (ATD) (3 cases), short-rib-polydactyly syndrome (SRPS) (1 case) and hypochondrogenesis (1 case). The gestational age ranged from 16 to 41 weeks. Of 6 fetuses that were born alive, 3 were ATD, 2 were TD and 1 was hypochondrogenesis.
TD was frequently complicated by hydramnios. Of 8 cases studied chromosomally, only 1 showed chromosomal abnormality -46XY, inv 9. Intrauterine growth retardation was frequently associated with OI. Pulmonary hypoplasia was present in 23 cases (79%), including all cases of ATD, SRPS and hypochondrogenesis, 11 in TD and 7 in OI. Other associated anomalies were present in 17 cases (59%).
- Well-Differentiated Papillary Mesothelioma of the Peritoneum: A case report .
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Yi Kyeong Chun, Yee Jeong Kim, Sung Ran Hong
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Korean J Pathol. 1998;32(9):697-699.
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- Well-differentiated papillary mesothelioma (WDPM) of the peritoneum is considered to be a distinct subtype of peritoneal mesothelioma and has mostly behaved in a benign fashion. We report a case of WDPM in a 48-year-old-woman. It was incidentally found during a hysterectomy for a uterine cervical carcinoma. Grossly, the tumor was composed of multiple peritoneal nodules, measuring up to 2 cm.
Microscopically, the nodules showed well-developed papillae lined by a single layer of cuboidal mesothelial cells.
Immunohistochemical staining revealed a positive reaction for cytokeratin and a negative reacion for carcinoembryonic antigen and Leu-M1. Ultrastructurally, the tumor cells showed numerous long, slender microvilli and desmosomes.
- Correlation of Heregulin mRNA and Her-2/neu Protein Expression with Node Metastasis and DNA Ploidy Pattern in Human Invasive Breast Carcinoma.
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Yee Jeong Kim, Woo Hee Jung, Hyde Lee, Sung Kong Lee, In Gul Moon, Kwang Gil Lee
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Korean J Pathol. 1998;32(8):563-573.
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Abstract
- The Her-2/neu protooncogene encodes a transmembrane tyrosine kinase that is structurally homologous to the receptor for epidermal growth factor. Its amplification and overexpression are associated with poor prognosis in breast cancer patients. Neu differentiation factor is a ligand for Her-2/neu protooncogene and was detected in ras-transformed rat fibroblasts. Heregulin (human homologue of neu differentiation factor) is a 44-kilodalton glycoprotein that stimulates tyrosine phosphorylation and induces growth arrest or stimulation and differentiation in human breast cancer cell lines. In this study we examined the expression of heregulin mRNA by nested reverse transcription (RT) PCR with fresh tissue, Her-2/neu protein, ICAM-1 and steroid receptors by immunohistochemistry, and DNA ploidy pattern by flow cytometry with paraffin-embedded tissue in invasive breast carcinoma. We compared the data with nodal status, lymphovascular invasion, steroid receptor status and DNA ploidy pattern. For RT-PCR to heregulin mRNA, 38 cases of fresh breast cancer tissue were obtained. Total 68 cases of invasive breast carcinoma tissue were fixed in formalin, which were used for routine histology, immunohistochemistry and flow cytometry. The results are as follows; 1) Heregulin mRNA was expressed in 86.1% of patients with invasive breast carcinoma and 100% of patients with benign breast lesion using nested RT-PCR analysis. 2) Her-2/neu protein was overexpressed in 50.0% of tumors using immunohistochemistry.
The expression of Her-2/neu protein was significantly correlated with high counts of lymph nodes with metastasis (p<0.05), and high nuclear grade (p<0.05). 3) Her-2/neu protein overexpression was significantly correlated with a high DNA index(p<0.05). All of the tumors showing Her-2/neu protein overexpression and no heregulin mRNA expression revealed near tetraploid DNA content. However, both Her-2/neu overexpression and heregulin mRNA expressing tumors revealed near tetraploidy in 38.9% and diploidy in 50.0%. Based on these results, heregulin mRNA expression rate was 86.1% in human invasive breast carcinoma. Her-2/neu protein overexpression is associated with high positive lymph node number and DNA index. Statistically significant reverse correlation with lymph node metastasis is not present.
- A Study for IL-6, IL-13 and TIMP-3 Expressions of Placenta, Fetus and Endometrium in Pregnant Mice after Treatment with Lipopolysaccharide.
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Sung Ran Hong, In Gul Moon, Ju Young Seoh, Yee Jeong Kim, Sung Sook Kim, Woon Sup Han
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Korean J Pathol. 1998;32(5):352-361.
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Abstract
- We examined C3H pregnant mice at 15 days (70% gestation) after treatment of lipopolysaccaride (LPS) to observe the changes of IL-6 concentration in maternal serum and amniotic fluid and expression of IL-6, IL-13 & TIMP-3 in placenta, fetus and endometrium, and to investigate the correlation among IL-6, IL-13 and TIMP-3. The results were as follows: 1) IL-6 in serum and amniotic fluid after treatment of LPS was significantly elevated; peaked at 1, 2, 4, 5 hours and decreased to control level at 8 hours (P<0.05). IL-6 in placental disc, chorioamnionic membrane, fetus, decidua and endometrial epithelium was overexpressed significantly at 1, 2, 4 hours after treatment of LPS (P<0.05). IL-6 overexpression was more significantly increased in maternal tissue than fetal tissue (P<0.05). 2) Increased concentration of amniotic fluid IL-6 was equally originated from transplacental crossage of maternal serum IL-6, and direct local production of IL-6 from placenta, fetus and endometrium (P<0.05). 3) IL-13 in placental disc, chorioamnionic membrane, fetus, decidua and endometrial epithelium was overexpressed after treatment of LPS, but not significant statistically. 4) TIMP-3 was overexpressed in placental disc, chorioamnionic membrane, fetus and decidua.
TIMP-3 overexpression was more significant in placental disc than other tissues (P<0.05). 5) Overexpressions in IL-13 and IL-6 revealed direct proportional correlation coefficient (Spearman correlation coefficient, 0.5212 ; P<0.05). IL-6 expression was a head of overexpression of TIMP-3, but not significant. In conclusion, all of IL-6, IL-13 and TIMP-3 relate with inflammatory response, especially IL-6 in maternal serum, amniotic fluid and tissue of placenta, fetus and endometrium was so sensitive that it can be an indicator for antenatal diagnosis of chorioamnonitis, and amniotic fluid IL-6 is equally originated from maternal serum and from tissue of placenta, fetus and endometrium. IL-13 and TIMP-3 may have parallel correlation to the IL-6 in fetal and maternal tissue after treatment of LPS.
- Carcinosarcoma (Malignant M llerian Mixed Tumor) of the Female Genital Tract: A clinical and pathologic study of ten carcinosarcomas.
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Sung Ran Hong, Yee Jeong Kim, Hy Sook Kim, Jae Uk Shim, Chong Taik Park
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Korean J Pathol. 1998;32(5):362-369.
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- Carcinosarcomas of the female genital tract have generally been regarded as a type of sarcoma. Recent studies, however, suggest the tumor may be more closely related to carcinoma and may represent metaplastic carcinoma in histogenesis. We analyzed clinicopathologic and immunohistochemical features of 10 carcinosarcomas to evaluate the relative importance of the carcinomatous and sarcomatous components in metastasis and recurrence. The primary tumor originated in the uterine body in seven cases, the uterine cervix in two and the ovary in one. Patient,s ages ranged from 54 to 71 years (mean, 64). The most common symptom of the uterine mass was vaginal bleeding. The median survival time was 21 months following diagnosis in five cases. Surgico-pathologic FIGO stages of five patients who received an operation were stage III and IV, but clinical FIGO stage of three patients (60%) among them were I. Lymphovascular invasions were identified in seven areas; five vascular invasion lesions showed the carcinomatous component alone, one the sarcomatous component alone, and remained one admixture of both components.
Metastatic and recurrent lesions to the paraaortic lymph node, ovary, pelvic wall, or vaginal vault showed characteristically carcinomatous component only.
Immunohistochemically, positive reactions for cytokeratin and epithelial membrane antigen were noted in the sarcomatous component of five cases. Vimentin positivity was detected in carcinomatous component of three cases. We conclude that the dominant element in carcinosarcomas of the female genital tract is the carcinomatous component. The survival rate of carcinosarcoma is extremely poor. The surgico-pathologic stage is better indicator of survival than the clinical stage. Immunohistochemical findings suggest that carcinosarcoma may represent a metaplastic carcinoma in histogenesis.
- Clinical Experience and Sensitivity of the AutoPap 300 QC System in Cervicovaginal Cytology.
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Sung Ran Hong, Jong Sook Park, Hoi Sook Jang, Yee Jeong Kim, Hy Sook Kim, Chong Taik Park, In Sou Park
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Korean J Cytopathol. 1998;9(1):37-44.
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- OBJECTIVE: False negatives of cervical smears due to screening errors pose a significant and persistent problem.
AutoPap 300 QC System, an automated screening device, is designed to rescreen conventionally prepared Pap smears initially screened by cytotechnologists as normal. Clinical experience and sensitivity of the AutoPap 300 QC System were assessed and compared with current 10% random quality control technique.
MATERIALS AND METHODS: In clinical practice, a total of 18,592 "within normal limits" or "benign cellular changes" cases classified by The Bethesda System were rescreened by the AutoPap System. In study for sensitivity of The AutoPap System to detect false negatives, a total of 1,680 "within normal limits" or "benign cellular changes" cases were rescreened both manually and by the AutoPap System. The sensitivity of the AutoPap System to these false negatives was assessed at 10% review rate to compare 10% random manual rescreen.
RESULTS
In clinical practice, 38 false negatives were identified by the AutoPap System and we had achieved 0.2% reduction in the false negative rate of screening error. In study for sensitivity, 37 false negatives were identified by manual rescreening, and 23 cases(62.2%) of the abnormal squamous cytology were detected by the AutoPap System at 10% review rate.
CONCLUSONS: The AutoPap 300 QC System is a sensitive automated rescreening device that can detect potential false negatives prior to reporting and can reduce false negative rates in the laboratory. The device is confirmed to be about eight times superior to the 10% random rescreen in detecting false negatives.
- Congenital Mesoblastic Nephromas with lmmunohistochemical and Flow Cytometric Analysis.
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Woo Hee Jung, Yee Jeong Kim, Jee Young Han, Woo Ick Yang, Dae Young Kang
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Korean J Pathol. 1995;29(3):303-310.
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- We reviewed 7 cases of congenital mesoblastic nephroma (4 cases of classical mesoblastic nephroma (CMN) and 3 cases of atypical mesoblastic nephroma (AMN)) using immuno-histochemical and flow cytometric study. Results are as follows. 1) The mean tumor size was 5 (3 to 7cm)cm in CMN and 9 (7 to 10cm)cm in AMN. The AMN revealed hemorrhage and necrosis in two Of three cases. A case of AMN showed cystic change without hemorrhage and necrosis. Mitotic count ranged in 0~4/10HPF in CMN and 20-35/10HPF in AMN. 2) Immunohistochemistry for vimentin was all positive. Actin, desmin were weakly positive in CMN, but negative in AMN. The findings were consistent with myofibroblastic differentiation in CMN and AMN was considered to be the less differentiated form of CMN. 3) Flow cytometiic analysis showed diploidy in two of two CMNs and two of three AMNs.
Only one AMN showed aneuploidy with DNA index of 1.41. %SG2M were 8.1 and 15.9 (mean 12.0) in CMN and 16.9, 32.9 and 19.3 (mean 22.9) in AMN, respectively. We concluded that AMN should be distinguished from CMN, clinicopathologically.
- Histological and Immunohistochemical Findings of the Endometrium in Ectopic and Intrauterine Pregnancy.
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Yee Jeong Kim, Soon Won Hong, Kyu Rae Kim, Chanil Park
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Korean J Pathol. 1995;29(1):33-39.
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- We reviewed histological and immunohistochemical findings of the endometrium in 28 cases of ectopic pregnancy and 11 cases of intrauterine pregnancy without chorionic villi or syncytiotrophoblast. 1) Twenty cases(71.41/o) of ectopic pregnancy revealed gestational patterns and 8 cases(28.6%) showed non-gestational patterns, which were menstrual phase in 3 cases, proliferative phase in I case, early secretary phase in 3 cases and mid secretary phase in 3 cases, respectively. Implantation sites were present in 36.40/o of intrauterine pregnancy. 2) Endometrial spiral arterioles tend to be more prominent with frequent intimal proliferation and thickening of the wall in intrauterine pregnancy than in ectopic pregnancy although it was not statistically significant(p=0.271). 3) Deposition of fibrinoid material in the endometrium was present in 72.7% of intrauterine pregnancy and 25% of ectopic pregnancy.
Thrombosis was present in 72.7% of intrauterine pregnancy and 5% of ectopic pregnancy. Hyalinized vessels were also present in 90.9% of intrauterine pregnancy and 200/o of ectopic pregnancy. These were statistically significant(p=0.0002, 0.0209 and 0.0004), but not diagnostic. 4) On immunohistochemical study for intrauterine pregnancy, the rates of positive reaction to human placental lactogen, cytokeratin and human chorionic gonadotropin were 45.5%, 45.5% and 9%, respectively. We concluded that HFIL and cytokeratin are reliable and sensitive markers for implantation site.
- Female Adnexal Tumor of probable Wolffian origin: A case report.
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Yee Jeong Kim, Sung Ran Hong, Hy Sook Kim, Hyon U Lee
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Korean J Pathol. 1994;28(4):427-429.
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- We report a case of right broad ligament tumor with features of female adnexal tumor of probable wolffian origin. A 40-year-old woman presented with dysfunctional uterine bleeding. Ultrasonography revealed 1 10cm sized right parovarian solid mass. On microscopic examination, the tumor showed mixed pattern of tightly packed tubular structures and diffuse spindle cell proliferation. Immunohistochemical study demonstrated cytokeratin-and vimentin-positivity and carcino-embryonic antigen-negativity. The ultrastructural study showed prominent tubular structures, continuous basal lamina, definite junctional complex but no secretory granules or glycogen particles, favoring wolffian origin.
- Cytologic Analysis of Microinvasive Squamous Cell Carcinoma of the Uterine Cervix.
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Eun Kyung Kim, Yee Jeong Kim, Jong Sook Park, Hy Sook Kim
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Korean J Cytopathol. 1994;5(2):99-105.
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- We studied cervical cytology of 175 cases of histologically confirmed microinvasive squamous cell carcinoma of the uterine cervix in Cheil General Hospital from 1991 to 1993.
Excluding 32 cases of insufficient smear, 143 cases were reviewed in view of background, cellularity, smear pattern, nuclear chromatin and presence of nucleoli. The characteristic findings of microinvasive carcinoma were syncytia and/or individual tumor cells in the focally necrotic inflammatory background. Nuclear chromatin was clear or fine. Nucleoli were observed in 55%. The prediction rate of microinvasive carcinoma was 74%. There is no significant relationship between the cellular features and depth of invasion.
- Inflammatory Pseudotumor of the Lymph Node: A case report.
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Yee Jeong Kim, Kun Chang Song, Woo Hee Jung, Woon Sup Han
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Korean J Pathol. 1993;27(2):164-168.
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- A 21-year-old man presented with a 7 days history of fever.
Careful clinical examination led to the discovery of left supraclavicular lymphadenopathy without hepatosplenomegaly.
Serologic tests for Ebstein-Barr virus, HIV, hepatitis type B & C, syphilis and typhoid fever were negative. Blood, urine, and stool cultures yielded no growth. Histologically, the process mainly involved the connective tissue framework of the lymph node, sharing the features of inflammatory pseudotmor(IPT) of other organs: a storiform growth pattern, increased vascularity with associated vascular lesions, and a polymorphous inflammatory infiltrate in a collagen-rich stroma. Immunohistochemical study for spindle cells showed positive reaction for actin and vimentin but not for desmin, and lymphoid cells revealed polyclonality. Characteristics of mass formation, and the inflammatory nautre of the process enabled us adopt the term IPT which should be differentiated from hematolymphoid proliferative disorder or mesenchymal neoplasia.
- Evaluation of "atypical squamous cells of undetermined significance" by the bethesda system.
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Yee Jeong Kim, Sung Ran Hong, Hy Sook Kim, Jong Sook Park, Kye Hyun Kim, Kyung Ho Lim, Jae Uk Shim, Chong Taik Park, Chong Soo Chun
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Korean J Cytopathol. 1993;4(2):81-86.
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- No abstract available.
- Rhabdomyosarcoma in Children: Histologic Subtypes and Prognosis.
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Woo Hee Jung, Yee Jeong Kim, Soon Hee Jung, Hyunee Yim, Cheol Joo Yoo
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Korean J Pathol. 1992;26(6):573-581.
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- Thirty cases of rhabdomyosarcoma in patients under the age of 15 years were reviewed retrospectively to find out characteristics of histologic subtypes related to prognosis.
Histologic diagnosis were embryonal in 21(70%), alveolar in 7(23%) and mixed type in 2(7%). Cellular anaplasia was noted in 6 cases. Round to polygonal cells with abundant eosinophilic cytoplasmic rim or globules were most characteristic cytologic feature or rhabdomyosarcomas, being followed by myofibrils. Myxoid and edematous stroma in embryonal type and alveolar pattern in alveolar type wee nost characteristic growth pattern. Immunohistochemically, tumors were positive for desmin, actin and myoglobin in 97%, 27%, and 40%, respectively. Consequently, characteristic cytologic features are important to differentiate rhabdomyosarcomas form other kinds of small round cell tumor and growth pattern is more critical in categorizing histologic subtypes. Desmin is far more useful than actin or myoglobin in the diagnosis of rhabdomyosarcoma.
- Histologic and Immunopathologic Study of Central Nervous System Lymphoma.
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Yee Jeong Kim, Tae Seung Kim, Woo Ick Yang, Kyu Rae Kim
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Korean J Pathol. 1992;26(5):476-483.
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- Twelve cases of primary malignant lymphoma of the central nervous system experienced between 1980 and 1990 were investigated by histological and immunohistochemical findings correlated with clinical observation. Of the 12 patients, 6 were male and 6 were female. Their ages ranged from 31 to 58 years(mean, 45.8 years). All Tumors were supratentorial except 1 case which was found in the spinal cord. The fronto-parietal lobe was the most common site, which accounted for 66.7%. Histologically, all the tumors showed unfavorable histology. Diffuse large cell type was the most frequent(66.7%). Immunohistochemical studies using monoclonal antibodies revealed predominance of B-cell phenotype. Although most cases were treated with a combination of surgery and irradiation, the outcome was poor in all.
- Changes of the Kupffer Cell Number in the Course of Metastasis of Hepatocellular Carcinoma.
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Chan Il Park, Yee Jeong Kim, Young Nyun Park, Sun Hee Sung
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Korean J Pathol. 1992;26(3):247-252.
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- The number of Kupffer cells was evaluated in hepatocellular carcinomas, including 18 primary lesions, 3 tumor emboli within the portal vein radicles and 4 metastatic lesions and in non-neoplastic liver adjacent to the primary lesions, to persue the origin of Kupffer cells dwelling in hepatocellular carcinoma. Hepatocellular carcinomas of the sinusoidal(trabecular) type were carefully selected, and excluded were those carcinomas which showed inflammation or other changes evoking inflammation. The immunohistochemical stains for CD 68 and lysozyme were done to identify Kupffer cells and to draw the mean Kupffer cell number per high power microscopic field of each lesion. Kupffer cell was most numerous in primary lesions followed by tumor emboli and still fewer in metastatic lesions. The Kupffer cell number in the primary lesions of hepatocellular carcinoma was in turn smaller than that of the adjacent non-neoplastic liver. The results suggest that, during the early neoplastic transformation, sinusoids of the non-neoplastic liver could creep into the carcinomatous tissue accompanying Kupffer cells.
- Cytologic findings of pancreatic islet cell tumor with lymph node metastasis.
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Yee Jeong Kim, Yoon Jung Choi, Kyu Rae Kim, Woo Hee Jung, Kwang Gil Lee
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Korean J Cytopathol. 1992;3(2):60-66.
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- No abstract available.
- Necrobiotic Xanthogranuloma with Paraproteinemia: A case report.
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Yee Jeong Kim, Kwang Gil Lee, Soo Il Chun, Hyung Soon Lee
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Korean J Pathol. 1991;25(6):589-593.
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- Necrobiotic xanthogranuloma(NXG) is a characteristic cutaneous manifestation associated with paraproteinemia. A case of NXG associated with an IgG (lambda) monoclonal gammopathy occurred in a 48-year-old man. Skin lesions were dome-shaped, hard palpable nodules, 2x3 cm to 4x4 cm sized, on both arms and forearms. They were arranged in a linear pattern. Also, hard palpable tumors, 1x2 cm to 2x3 cm in size, were present on the left leg and the dorsum of the left foot. They were violaceous, slightly protruded, and hard on palpation. Histologically, the lesion was characterized by inflammatory xanthogranuloma with broad hands of hyaline necrobiosis. Many foreign body type of bizarre giant cells, Touton type of giant cells and foamy histiocytes were infiltrated into the dermis and subcutaneous fat tissue. Three days after medication with ledercort and immuran, the cutaneous masses decreased in size and became soft.
- Placental Site Trophoblastic Tumor(PSTT) with Vaginal Metastasis: A case report.
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Yee Jeong Kim, Kyu Rae Kim, Soon Hee Jeong, Ho Geun Kim, Jang Yeon Kwon
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Korean J Pathol. 1991;25(6):570-575.
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- PSTT has been established as a separate entity distinct from choriocarcinoma since 1983, because of its different morphological features, biologic behavior and response to chemotherapy. Most cases of PSTT have indolent clinical courses, but there have been several reports showing malignant behavior resulted in death of the patient. We report a case of PSTT showing vaginal metastatis. In biopsy specimen, it was difficult to make differential diagnosis from squamous cell carcinoma of uterine cervix due to uniform and mononuclear cytologic characteristics.
Immunohistochemical stains for hPL and hCG were not typical for either PSTT or choriocarcinoma. We suggest that poorly differentiated PSTT may synthesize the lesser amount of hPL than typical PSTT and it may behave more aggressively.
- A Pathologic Study of Lymphoproliferative Disorders of the Skin.
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Yee Jeong Kim, Kwang Gil Lee, Soo Il Chun, Yun Woong Ko
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Korean J Pathol. 1991;25(6):551-562.
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- Forty eight skin biopsies obtained from 24 patients were reviewed, and clinical, histological and immunohistochemical findings were analyzed. Results obtained are as follows: 1) Skin manifestation was plaque, erythroderma, scale and hyperpigmentation in mycosis fungoides, and subcutaneous nodule, mass and ulcerated patch in cutaneous lymphoma. The skin of lymphomatoid papulosis revealed hemorrhagic ulcerated and erythematous papules which healed spontaneously. 2) Histologically, mycosis fungoides showed epidermotropism in most cases. Pautrier's micro-abscesses were present in one-fourth of the cases. Malignant lymphoma was different in histology from mycosis fungoides. As compared with mycosis fungoides, it showed less frequent epidermotropism, more compact and diffuse infiltration of atypical lymphocytes, more often association with ulcer and necrosis, and more frequent mitotic figures. Lymphomatoid papulosis showed striking hemorrhage and edema of the papillary dermis. 3) Based on the results of immunohistochemical study, mycosis fungoides and lymphomatoid papulosis were considered as a T cell proliferative disorder of the skin. According to these findings, lymphoproliferative disorders of the skin occurred predominantly in the elderly and males. Clinical and histopathologic findings overlapped and were similar each other. It was difficult to make a definite diagnosis in early lesions, and a sequential follow up biopsy was required. It is concluded that strict criteria such as marked atypia and clustering of atypical cells are necessary for a histologic diagnosis of malignant lymphoproliferative disorder of the skin.
- Fine needle aspiration cytology of mediastinal goiter.
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Yee Jeong Kim, Kwang Gil Lee
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Korean J Cytopathol. 1991;2(2):148-152.
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Abstract
- No abstract available.
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