Journal of Pathology and Translational Medicine

Young Kyung Bae

25 Articles

HER2-Positive Breast Carcinomas with Co-amplification or Gain of Chromosome 17 Centromere Locus: Report of Three Cases and an Impact on HER2 Testing.: Hyeong Chan Shin, Young Kyung Bae, Aeri Kim, Seok Ju Park; Korean J Pathol. 2011;45(6):665-669.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.6.665

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Abstract PDF: Recently we experienced three cases of human epidermal growth factor receptor 2 (HER2)-amplified invasive breast carcinomas associated with co-amplification or gain of chromosome 17 centromere (CEP17) in silver-enhanced in situ hybridization (SISH) analysis. These cases revealed 2+ or 3+ staining for HER2 immunohistochemistry and >6 HER2 copies per cell on SISH analyses. However, the calculated HER2/CEP17 ratios were low (<2.2) and did not fit within the HER2-positive category. We interpreted those cases as HER2-positive tumors based on the number of HER2 copies per cell. There is a potential for misinterpretation of SISH analysis in cases showing increased CEP17 copy number, based on the criterion used for HER2 positivity (HER2 copies >6 per cell vs HER2/CEP17 ratio>2.2). We recommend reporting raw SISH or fluorescence in situ hybridization data, including number of cells counted, average numbers of HER2 and CEP17 signals, and the calculated HER2/CEP17 ratio to prevent underreporting of HER2 amplification.

Diagnostic Importance of Recognition of Calcareous Corpuscles and Larva Part in the Diagnosis of Sparganosis by Fine Needle Aspiration Cytology: Reports of Three Cases of Mammary Sparganosis.: Woo Jung Sung, Seok Ju Park, Young Kyung Bae, Mi Jin Kim; Korean J Pathol. 2011;45(5):542-546.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.5.542

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Abstract PDF: Sparganosis of the breast is an uncommon disease. Cytological granulomatous inflammation is a common feature of sparganosis. The presence of larval fragments is necessary for a definitive diagnosis of sparganosis in a cytological specimen. However, calcareous corpuscles entrapped in necrotic debris can be very diagnostic for sparganosis in endemic areas. We experienced three cases of mammary sparganosis diagnosed by fine needle aspiration cytology before surgical excision. Two cases showed numerous calcareous corpuscles associated with necrotic debris thought to be degenerated parasitic bodies. The remaining case revealed a few degenerative calcareous corpuscles and parasitic bodies. The presence of calcareous corpuscles and/or degenerative parasitic bodies can be an aid in the differential diagnosis between sparganosis and other forms of granulomatous mastitis, particularly in endemic areas of sparganosis.

HER2 Status in Gastric Adenocarcinomas Assessed by Immunohistochemistry, Automated Silver-Enhanced In Situ Hybridization and Fluorescence In Situ Hybridization.: Aeri Kim, Jung Min Bae, Se Won Kim, Mi Jin Gu, Young Kyung Bae; Korean J Pathol. 2010;44(5):493-501.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.5.493

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Abstract PDF

BACKGROUND
Recently, many studies have focused on human epidermal growth factor receptor 2 (HER2) status in gastric cancer due to HER2-targeted therapy using trastuzumab. We investigated HER2 overexpression and amplification and their concordance rate in Korean gastric adenocarcinomas.
METHODS
Tissue microarrays were constructed with 232 gastric adenocarcinoma samples. We performed immunohistochemistry (IHC), silver-enhanced in situ hybridization (SISH) and fluorescence in situ hybridization (FISH) for HER2.
RESULTS
IHC was negative in 94.8% (218/232), equivocal in 1.7% (4/232) and positive in 3.5% (8/232) of cases. HER2 protein expression was heterogeneous in 75% (9/12) of IHC 2+/3+ cancers. Gene amplification was observed in 6.5% (15/230) by SISH and the same 15 cases were also FISH-positive. We observed HER2 amplification in 1.4%, 27.3%, 25%, and 100% of IHC 0, 1+, 2+, and 3+ gastric adenocarcinomas, respectively. The concordance rate between IHC and SISH results was 95.7%.
CONCLUSIONS
HER2 overexpression and amplification were less frequent in gastric adenocarcinomas than breast carcinomas. Compared to breast carcinoma, (1) there may be IHC-negative but gene amplification-positive cases for HER2 and (2) frequent intratumoral heterogeneity of IHC for HER2 in gastric adenocarcinomas.

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Epidemiologic Study of Human Epidermal Growth Factor Receptor 2 Expression in Advanced/Metastatic Gastric Cancer: an Assessment of Human Epidermal Growth Factor Receptor 2 Status in Tumor Tissue Samples of Gastric and Gastro-Esophageal Junction Cancer
Kyung Won Seo, Taeyong Jeon, Sewon Kim, Sung Soo Kim, Kwanghee Kim, Byoung-Jo Suh, Sunhwi Hwang, SeongHee Choi, Seungwan Ryu, Jae Seok Min, Young-Joon Lee, Ye Seob Jee, Hyeondong Chae, Doo Hyun Yang, Sang Ho Lee
Journal of Gastric Cancer.2017; 17(1): 52. CrossRef
Synopsis on Clinical Practice Guideline of Gastric Cancer in Korea: An Evidence-Based Approach
Jun Haeng Lee, Jae G. Kim, Hye-Kyung Jung, Jung Hoon Kim, Woo Kyoung Jeong, Tae Joo Jeon, Joon Mee Kim, Young Il Kim, Keun Won Ryu, Seong-Ho Kong, Hyoung Il Kim, Hwoon-Yong Jung, Yong Sik Kim, Dae Young Zang, Jae Yong Cho, Joon Oh Park, Do Hoon Lim, Eun S
The Korean Journal of Gastroenterology.2014; 63(2): 66. CrossRef
Clinical Practice Guidelines for Gastric Cancer in Korea: An Evidence-Based Approach
Jun Haeng Lee, Jae G. Kim, Hye-Kyung Jung, Jung Hoon Kim, Woo Kyoung Jeong, Tae Joo Jeon, Joon Mee Kim, Young Il Kim, Keun Won Ryu, Seong-Ho Kong, Hyoung-Il Kim, Hwoon-Yong Jung, Yong Sik Kim, Dae Young Zang, Jae Yong Cho, Joon Oh Park, Do Hoon Lim, Eun S
Journal of Gastric Cancer.2014; 14(2): 87. CrossRef

Gene Expression Profiles of Uterine Normal Myometrium and Leiomyoma and Their Estrogen Responsiveness In Vitro.: Eun Ju Lee, Prati Bajracharya, Dong Mok Lee, Kyung Hyun Cho, Keuk Jun Kim, Young Kyung Bae, Mi Jin Kim, Ki Ho Lee, Hang Jin Kim, Gun Ho Song, Sang Sik Chun, Inho Choi; Korean J Pathol. 2010;44(3):272-283.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.3.272

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BACKGROUND
Uterine leiomyomas are common benign smooth muscle tumors among the reproductive aged-women. The research has been aimed to identify the differentially expressed genes between normal myometrium and leiomyoma and to investigate the effects of E2 on their expression.
METHODS
Gene microarray analysis was performed to identify the differentially expressed genes between normal myomerium and leiomyoma. The data was confirmed at protein level by tissue microarray.
RESULTS
Gene microarray analysis revealed 792 upregulated genes in leiomyoma. Four genes (tropomyosin 4 [TPM4], collagen, type IV, alpha 2 [COL4alpha2], insulin-like growth factor binding protein 5 [IGFBP5], tripartite motif-containing 28 [TRIM28]) showed the most dramatic upregulation in all leiomyoma samples. Tissue microarray analyses of 262 sample pairs showed significantly elevated expression of TPM4, IGFBP5, estrogen receptor-alpha, and progesterone receptor (PR) protein in leiomyoma from the patients in their forties, COL4alpha2 in the forties and fifties age-groups, and TRIM28 in the thirties age-group. PR, insulin-like growth factor 1 (IGF-1), IGF-1 receptor (IGF-1R) and IGFBP5 were induced by E2 in in vitro culture of tissue explants from which cells migrated throughout the plate. Among these, PR, IGF-1, IGFBP5 genes showed higher expression in tissue compared to cells-derived from tissue in leiomyoma and IGF-1R in leiomyoma cell.
CONCLUSIONS
This observation implies the importance of the whole tissue context including the cells-derived from tissue in the research for the understanding of molecular mechanism of leiomyoma. Here, we report higher expression of TRIM28 in leiomyoma for the first time and identify E2-responsive genes that may have important roles in leiomyoma development.

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In vivo mechanisms of uterine myoma volume reduction with ulipristal acetate treatment
Guillaume E. Courtoy, Jacques Donnez, Etienne Marbaix, Marie-Madeleine Dolmans
Fertility and Sterility.2015; 104(2): 426. CrossRef
Common fibroid-associated genes are differentially expressed in phenotypically dissimilar cell populations isolated from within human fibroids and myometrium
Sarah J Holdsworth-Carson, Marina Zaitseva, Jane E Girling, Beverley J Vollenhoven, Peter A W Rogers
REPRODUCTION.2014; 147(5): 683. CrossRef
Complex networks of multiple factors in the pathogenesis of uterine leiomyoma
Md Soriful Islam, Olga Protic, Piergiorgio Stortoni, Gianluca Grechi, Pasquale Lamanna, Felice Petraglia, Mario Castellucci, Pasquapina Ciarmela
Fertility and Sterility.2013; 100(1): 178. CrossRef

Usefulness of DOG1 Expression in the Diagnosis of Gastrointestinal Stromal Tumors.: Jun Mo Kim, Aeri Kim, Joon Hyuk Choi, Young Kyung Bae; Korean J Pathol. 2010;44(2):141-148.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.2.141

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BACKGROUND
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the gastrointestinal tract. Expression of KIT protein (CD117) is an important diagnostic criterion of GIST. However, about 5% of GISTs are CD117 negative. Discovered on GIST 1 (DOG1) was introduced recently as a promising marker for GIST. We tested this new antibody in 105 GISTs tissue specimens, including 6 cases of metastatic GISTs, to determine the usefulness of DOG1 expression in the diagnosis of GISTs.
METHODS
We performed immunohistochemical (IHC) staining for DOG1 and CD117 on tissue microarrays that included 70 gastric GISTs, 29 small intestinal GISTs, 6 metastatic GISTs, 14 gastric leiomyomas and 16 gastric schwannomas.
RESULTS
DOG1 was positive in 98.1% (103/105) of GISTs and CD117 was positive in 97.1% (102/105) of GISTs. Only 1 case was negative for both markers. Two (66.7%) out of 3 GISTs tested CD117 negative were tested DOG1 positive. All leiomyomas and schwannomas were negative for both DOG1 and CD117.
CONCLUSIONS
DOG1 was highly expressed in GIST including CD117 negative cases. Adding DOG1 testing to the IHC panel for diagnosing GIST will help to identify GIST patients who are CD117 negative but may otherwise benefit from targeted therapy.

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Gastrointestinal tract spindle cell tumors with interstitial cells of Cajal: Prevalence excluding gastrointestinal stromal tumors
So Jung Lee, Chung Su Hwang, Ahrong Kim, Kyungbin Kim, Kyung Un Choi
Oncology Letters.2016; 12(2): 1287. CrossRef

Automated Silver-enhanced In Situ Hybridization for Evaluation of HER2 Gene Status in Breast Carcinoma: Comparison with Fluorescence In Situ Hybridization and Immunohistochemistry.: Woo Jung Sung, Seok Ju Park, Mi Jin Gu, Young Kyung Bae; Korean J Pathol. 2010;44(1):28-34.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.1.28

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BACKGROUND
The human epidermal growth factor receptor 2 (HER2) is amplified in 20-25% of breast cancers. HER2 overexpression or amplification is associated with a worse clinical outcome and it can predict the benefit from anthracycline and anti-HER2 therapies. The HER2 status has usually been assessed by immunohistochemistry (IHC) or fluorescence in situ hybridization (FISH) in clinical samples. A new silver-enhanced in situ hybridization (SISH) technique was recently introduced. Therefore we evaluated the usefulness of SISH for detecting HER2 amplification.
METHODS
Tissue microarrays (TMAs) were constructed with 144 invasive breast cancer tissue samples. We performed IHC, FISH and SISH for HER2 on the tissue sections from the TMAs and we interpreted the results according to the American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guidelines. The concordant rates between the two different tests were calculated.
RESULTS
HER2 was overexpressed and amplified in 16.9%, 16.9%, and 18% of the cases by IHC, FISH and SISH, respectively. The concordant rates between IHC and FISH, IHC and SISH, and FISH and SISH were 95.1%, 95.7%, and 97.8%, respectively.
CONCLUSIONS
SISH can be an alternative test for evaluating HER2 amplification because the 97.8% concordance with FISH satisfies the ASCO/CAP requirement of > 95% concordance with an alternative validated method.

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HER2 assessment by silverin situhybridization: where are we now?
Francesca Sanguedolce, Pantaleo Bufo
Expert Review of Molecular Diagnostics.2015; 15(3): 385. CrossRef
Diagnostic Effectiveness of PCR-based Tests DetectingBRAFMutation for Treating Malignant Melanoma: A Systematic Review
Hae-Won Shin, Ryeo-Jin Ko, Min Lee, Hee-Young Bang, Kye-Chul Kwon, Jong-Woo Park, Sun-Hoe Koo
Laboratory Medicine Online.2014; 4(4): 203. CrossRef
Effectiveness of Silver-enhanced In Situ Hybridization for Evaluating HER2 Gene Status in Invasive Breast Carcinoma: A Comparative Study
Youngseok Lee, Youngjoon Ryu, Hoiseon Jeong, Hyeyoon Chang, Younghye Kim, Aeree Kim
Archives of Medical Research.2012; 43(2): 139. CrossRef
HER2 Status by Standardized Immunohistochemistry and Silver-EnhancedIn SituHybridization in Korean Breast Cancer
Young Kyung Bae, Gyungyub Gong, Jun Kang, Ahwon Lee, Eun Yoon Cho, Ji Shin Lee, Kwang-Sun Suh, Dong Wha Lee, Woo Hee Jung
Journal of Breast Cancer.2012; 15(4): 381. CrossRef
Multiplication of Chromosome 17 Centromere Is Associated with Prognosis in Patients with Invasive Breast Cancers Exhibiting NormalHER2andTOP2AStatus
Aeri Kim, Hyung Chan Shin, Young Kyung Bae, Min Kyoung Kim, Su Hwan Kang, Soo Jung Lee, Eun Hee Lee
Journal of Breast Cancer.2012; 15(1): 24. CrossRef
HER2-Positive Breast Carcinomas with Co-amplification or Gain of Chromosome 17 Centromere Locus: Report of Three Cases and an Impact on HER2 Testing
Hyeong Chan Shin, Young Kyung Bae, Aeri Kim, Seok Ju Park
The Korean Journal of Pathology.2011; 45(6): 665. CrossRef
The Effectiveness of SilverIn SituHybridization in Patients with Breast Cancer: A Systematic Review
Sunyoung Jang, Seon-Heui Lee, Soojin Kim, You-Kyoung Lee, Young-Hyuck Im, Wonshik Han, Hee-Sook Park
Journal of Breast Cancer.2011; 14(Suppl 1): S1. CrossRef
Clinical and health economic outcomes of alternative HER2 test strategies for guiding adjuvant trastuzumab therapy
James A Lee, Megan Shaheen, Thomas Walke, Matt Daly
Expert Review of Pharmacoeconomics & Outcomes Research.2011; 11(3): 325. CrossRef
HER2 expression in breast cancer: Comparisons of fluorescence in situ hybridization and silver in situ hybridization, and immunohistochemical staining using monoclonal antibody and polyclonal antibody
Jung Sik Jang, Eun Jeong Jang, Ji‐Young Park
Basic and Applied Pathology.2010; 3(4): 115. CrossRef
HER2Status in Gastric Adenocarcinomas Assessed by Immunohistochemistry, Automated Silver-EnhancedIn SituHybridization and FluorescenceIn SituHybridization
Aeri Kim, Jung Min Bae, Se Won Kim, Mi Jin Gu, Young Kyung Bae
The Korean Journal of Pathology.2010; 44(5): 493. CrossRef

Morphological Features of Metastatic Gastrointestinal Stromal Tumors after Gleevec Treatment: Two Cases Report.: Joon Hyuk Choi, Young Kyung Bae, Sun Kyo Song, Hong Jin Kim, Min Chul Shim, Kyung Hee Lee; Korean J Pathol. 2009;43(4):368-373.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.4.368

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Abstract PDF: We report two patients with metastatic gastrointestinal stromal tumors (GISTs) with a focus on the morphological features related to Gleevec treatment. In case 1, a 50-year-old woman presented with a 1.8 cm metastatic GIST in the liver after resection of a gastric GIST. Majority of the metastatic tumor showed fibrosis and hyalinization after 8 weeks of Gleevec treatment. CD117-positive cells were present in approximately 1% of the overall tumor. In case 2, a 2 cm and 14 cm metastatic liver masses were found in a 54-year-old man who had a rectal GIST. After 4 weeks of Gleevec treatment, metastatic tumors showed a decrease in size on CT scan. The metastatic tumors showed a decrease in number of tumor cells. The hemorrhage, cystic changes, necrosis, and fibrosis made up approximately 90% of the tumor. The morphological features related to Gleevec treatment are important for correct diagnosis and evaluation of tumor response and prognosis.

Gastric Adenocarcinoma with Coexistent Hepatoid Adenocarcinoma and Neuroendocrine Carcinoma: A Case Report.: Aeri Kim, Sang Woon Kim, Sun Kyo Song, Young Kyung Bae; Korean J Pathol. 2009;43(1):79-82.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.1.79

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Abstract PDF

This report represents a very rare case of a gastric adenocarcinoma that was coexistent with hepatoid adenocarcinoma and neuroendocrine carcinoma. A 77-year-old man was admitted to our hospital due to a huge ulcerofungating mass identified at the proximal body of the stomach. After a pathological diagnosis of the tumor as a poorly differentiated adenocarcinoma was made, the patient underwent a total gastrectomy with lymph node dissection. Microscopically, the tumor consisted of three morphologically distinct components-tubular adenocarcinoma, hepatoid adenocarcinoma and neuroendocrine carcinoma. The hepatoid adenocarcinoma component resembled a hepatocellular carcinoma and produced alpha-fetoprotein. The neuroendocrine carcinoma component was positive for chromogranin and synaptophysin immunostains. This is an example of the diverse morphological and immunophenotypical differentiation of gastric carcinomas.

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An Intestinal Type Gastric Neuroendocrine Tumor: A Case Report
Mohammad Abu-Jeyyab, Renata Kakish, Malak Alkatib, Leen Alshawabkeh, Rawan Bani Hamad, Mary Almadani, Ma'wia Santarisi, Mohammad Al-Jafari, Abdulqadir J. Nashwan
Case Reports in Oncology.2023; 16(1): 1113. CrossRef
Gastric adenocarcinoma is concurrent with metastatic neuroendocrine cancer treated with nivolumab and chemotherapy: A case report
Bing Yan, Meiqi Cui, Junhao You, Fang Li, Hui Liu
Molecular and Clinical Oncology.2018;[Epub] CrossRef

Prognosis of Gastrointestinal Stromal Tumors Arising in the Stomach and Small Intestine: A Retrospective Study of 126 Cases from a Single Institution.: Sang Hee Seok, Jun Mo Kim, Jung Min Bae, Se Won Kim, Sang Woon Kim, Sun Kyo Song, Young Kyung Bae; Korean J Pathol. 2008;42(6):335-343.

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Abstract PDF: BACKGROUND
Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor in the gastrointestinal tract. As all GISTs have the potential for aggressive clinical behavior, the guidelines for defining the risk of aggressive behavior have been developed and they have been recently revised to precisely assess these patients' prognosis.
METHODS
We analyzed 94 gastric and 32 small intestinal GISTs to compare the patients' survival with the risk stratification (original and revised). RESULTS: For gastric GISTs, 10 mitoses/50HPF was an important cutoff value for the risk of metastasis (1.3% vs 29.4%, respectively), whereas 16.7% of all the small intestinal GISTs with less than 5 mitoses/50HPF metastasized. The small intestinal GISTs showed higher frequencies of mucosal invasion and coagulation necrosis than did the gastric ones. Gastric GISTs had a significantly lower incidence of metastasis/recurrence than did the small intestinal ones in the same risk group. On multivariate analysis, the anatomic location (small intestine), the tumor size (>10 cm) and the mitotic count (>10/50HPF) were independent prognostic factors for a shorter disease-free survival for patients with GISTs. The mitotic count was more important than tumor size for both gastric and small intestinal GISTs.
CONCLUSION
Small intestinal GIST is a more aggressive tumor than gastric GIST and the mitotic count is the most important prognostic factor for GISTs.

Reduced Expression of Claudin-7 Correlates with Invasiveness and Nuclear Grade of Breast Carcinomas.: Sang Hee Seok, Su Hwan Kang, Soo Jung Lee, Tae Yoon Hwang, Young Kyung Bae; Korean J Pathol. 2007;41(3):158-164.

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Abstract PDF: Background
: Claudins are important components of the tight junctions in the intercellular barriers and cell polarity. Among them, claudin-7 is down-regulated in breast cancers compared with the normal breast epithelium. The aim of this study was to determine the expression pattern and prognostic value of claudin-7 in breast carcinomas.
Methods
: Claudin-7 expression was evaluated immunohistochemically in 42 cases of ductal carcinoma in situ (DCIS) and in 142 cases of invasive breast carcinoma (IBC) using a tissue microarray (TMA).
Results
: Claudin- 7 was strongly expressed in the normal luminal epithelial cells in the breast lobule. The level of claudin-7 expression was significantly lower or absent in 45.2% (19/42) of DCIS and 72.5% (103/142) of IBC. A loss or reduced expression of claudin-7 correlated with the invasiveness (p=0.001) of breast carcinomas and a high nuclear grade (p=0.013) in IBC.
Conclusion
Claudin-7 is an important tight junction protein in the breast and a loss of expression may assist in the dissociation and invasion of tumor cells.

Ectopic Hamartomatous Thymoma: A Case Report along with a Review of the Literature Concerning the Histogenesis and New Nomenclature.: Sang Hee Seok, Dong Hyun Lee, Su Hwan Kang, Young Kyung Bae; Korean J Pathol. 2006;40(4):292-296.

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Abstract PDF: Ectopic hamartomatous thymoma (EHT) is a rare and distinctive benign neoplasm of the lower neck. We here report on a case of EHT arising in the suprasternal area of 47-year-old male patient. The well-circumscribed mass measured 7 x 6 x 4 cm and it predominantly had a solid gray-white cut surface. Microscopically, the tumor consisted of spindle cells, epithelial nests, and mature adipose tissue. The epithelial component was arranged in anastomosing cords, solid nests and variable-sized cysts that were lined by squamous or cuboidal epithelium. The spindle cells revealed the myoepithelial immunohistochemical phenotype. There was no obvious thymic differentiation nor was any normal thymic tissue observed in our case. We think that EHT needs to be reclassified with using different nomenclature to designate its origin and histology. Further, pathologists and clinicians should be aware of the existence of this tumor in the lower neck so as not to mistake it for high-grade sarcoma or spindle cell carcinoma.

Synovial Sarcoma with Massive Myxoid Feature: A Case Report.: Joon Hyuk Choi, Young Ran Shim, Young Kyung Bae, Mi Jin Kim, Duk Seop Shin, Kil Ho Cho; Korean J Pathol. 2005;39(4):273-277.

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Abstract PDF: Focal myxoid change in synovial sarcoma is not uncommon, although the presence of predominantly myxoid stroma is very rare. Recognition of synovial sarcomas with massive myxoid feature is important because these can easily be mistaken for other myxoid soft tissue neoplasms. We report a case of a synovial sarcoma with massive myxoid feature in the left thigh of a 54-year-old woman. Wide excision of an 8.5*7.0*5.0 cm, well-circumscribed and lobulated tumor was performed. The cut surface was gray, soft, and myxoid. Histological examination showed proliferation of spindle cells in the predominantly myxoid stroma. There were small areas with features more typical of synovial sarcoma, including uniform, spindled cells with fascicular growth patterns, collagenous stroma, mast cell infiltration, and hemangiopericytoma-like vascular patterns. Immunohistochemical examination showed focal positivity of the tumor cells for epithelial membrane antigen (EMA). Tumor cells were all negative for cytokeratin (AE1/AE3), cytokeratin 7, S-100 protein, smooth muscle actin, and desmin. Ultrastructurally, tumor cells showed desmosomes and microvilli. Our case underscores that, in order to make a correct diagnosis, immunohistochemical and ultrastructural examination is essential.

Cribriform-Morular Variant of Papillary Thyroid Carcinoma: A Report of Two Cases.: Young Ran Shim, Young Kyung Bae, Joon Hyuk Choi, Mi Jin Kim, Won Hee Choi; Korean J Pathol. 2005;39(1):48-53.

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Abstract PDF: Cribriform-morular variant of papillary thyroid carcinoma is an unusual and peculiar subtype of papillary thyroid carcinomas. It occurs both sporadically and in association with familial adenomatous polyposis. We report here on two cases of cribriform-morular variant of papillary thyroid carcinoma in a 33-year-old woman and in a 21-year-old woman. On gross examination, both cases were multicentric. The first case showed two well-encapsulated yellow solid masses in the right (2.0 cm) and the left lobes of the thyroid gland (0.5 cm). The second case showed four well-encapsulated gray-white solid lobulating masses and nodules in the right (4.5 and 1.2 cm) and the left lobes (1.1 and 0.8 cm) of the thyroid gland. Microscopically, both cases exhibited an intricate blending of papillary, cribriform, trabecular, spindle, and solid patterns of growth with morular areas. Typical nuclear features of papillary carcinomas were focally seen. Immunohistochemically, the tumor cells were positive for thyroglobulin, thyroid transcription factor-1 (TTF-1), and beta-catenin, but were negative for calcitonin.

Chronic Intestinal Pseudoobstruction Associated with Inflammatory Visceral Neuropathy: A Case Report.: Young Kyung Bae, Joon Hyuk Choi, Mi Jin Kim, Dong Sug Kim, Won Kyu Park, Jae Hwang Kim; Korean J Pathol. 2004;38(3):191-195.

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Abstract PDF: The pathogenesis of chronic intestinal pseudoobstruction (CIP) presents a broad spectrum of etiologies. Among them, visceral neuropathy and myopathy are two major pathologic conditions. We report here on a very rare case of CIP associated with inflammatory visceral neuropathy involving the terminal ileum, appendix and entire colon in a 64-year-old woman who did not have any detectable neoplasm or family history of this disease. Microscopically, the submucosal and myenteric plexuses showed a severe and diffuse lymphoplasmacytic infiltrate with degenerative changes of the ganglion cells and nerve fibers. The pathogenesis of the inflammatory reaction is unclear for our patient, but we think that this would be a rare example of idiopathic and sporadic visceral neuropathy resulting in chronic intestinal pseudoobstruction.

Expression of Matrix Metalloproteinase-2 (MMP-2) and Tissue Inhibitor of Metalloproteinase-2 (TIMP-2) in Pancreatic Ductal Adenocarcinoma.: Mi Jin Gu, Young Kyung Bae, Joon Hyuk Choi; Korean J Pathol. 2004;38(2):73-78.

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Abstract PDF: BACKGROUND
Matrix metalloproteinase-2 (MMP-2) is known to be one of the key molecules for tumor invasion and metastasis. MMP-2 activity is modulated through interaction with the tissue inhibitor of metalloproteinase-2 (TIMP-2). The purpose of this study was to evaluate the expression of MMP-2 and TIMP-2 in pancreatic ductal adenocarcinoma.
METHODS
Using immunohistochemical staining, we investigated the expression of MMP-2 and TIMP-2 in 30 pancreatic ductal adenocarcinomas and 10 normal pancreas.
RESULTS
MMP-2 expression was present in tumor cells in 11 cases, and in stromal cells in 24 cases, out of 30 carcinomas. MMP-2 expression of tumor cells was significantly higher in poorly differentiated adenocarcinomas than in well/moderately differentiated adenocarcinomas, and in cases with vascular invasion than in cases without. MMP-2 expression was stronger in the marginal areas than in the central area of the tumor. TIMP-2 expression was detected in the tumor and stromal cells of all carcinomas. MMP-2 and TIMP-2 expression had no significant correlation with tumor size, lymph node metastasis, or TNM stage. MMP-2 expression was not correlated with TIMP-2 expression.
CONCLUSIONS
These results suggest that MMP-2 expression may play an important role in the invasive property of pancreatic ductal adenocarcinoma, whereas TIMP-2 expression increases as a reaction to invasion.

Imprint Cytologic Features of Poorly Differentiated Synovial Sarcoma: A Case Report.: Mi Jin Gu, Joon Hyuk Choi, Young Kyung Bae; Korean J Cytopathol. 2003;14(1):27-31.

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Abstract PDF: Poorly differentiated synovial sarcoma is a variant of synovial sarcoma. We report a case of poorly differentiated synovial sarcoma imprinted after resection. The patient was a 47-year-old woman with a right shoulder pain for 6 months. The cytologic features showed malignant round to oval, monotonous tumor cells with high nuclear to cytoplasmic ratio. Some tumor cells showed perivascular distribution and nuclear molding. Vague rosette-like structures were seen. On immunohistchemical stains, tumor cells were diffusely positive for CD99 and focally positive for epithelial membrane antigen. Ultrastructural examination showed desmosomes and microvilli.

Nasal Inverted Papilloma Associated With Squamous Cell Carcinoma: A Report of Two Cases.: Mi Jin Gu, Dong Sug Kim, Young Kyung Bae, Yong Dae Kim; Korean J Pathol. 2001;35(3):248-281.

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Abstract PDF: Nasal inverted papilloma (IP) is a benign neoplasm that may be associated with squamous cell carcinoma (SCC). Several studies have suggested that human papilloma virus 16/18 (HPV 16/18) and p53 are closely related to the pathogenesis of IP with transformation to squamous cell carcinoma (IP-SCC). This study was conducted to investigate the role of HPV 16/18 and p53 in the pathogenesis of IP-SCC using immunohistochemistry. We studied two cases of IP-SCC and 10 cases of IP. None of the IP cases presented positivity for HPV 16/18 or p53 protein. Two cases of IP-SCC showed negative reactions for HPV 16/18. The SCC portion of the IP-SCC showed strong positivity for p53, while the IP portion of the IP-SCC was negative for p53. MIB-1 labeling index (LI) was estimated in the IP cases and the IP-SCC as well. In terms of MIB-1 LI, there was no statistical significance between IP and IP-SCC, and between the IP portion and the SCC portion in the cases of IP-SCC. In conclusion, we believe that alteration of the p53 protein is related to IP with malignant transformation, but further studies are required to investigate the correlation of HPV 16/18 and p53 in the pathogenesis of IP with malignant transformation, and the significance of the MIB-1 LI and p53 as biomarkers in IP.

Telomerase mRNA Expression by In Situ Hybridization in Premalignant Lesions and Carcinomas of the Breast.: Young Kyung Bae, Dong Sug Kim, Soo Jung Lee, Koing Bo Kwun; Korean J Pathol. 2001;35(1):53-59.

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Abstract PDF: BACKGROUND
Telomerase is a ribonucleoprotein, DNA polymerase that synthesizes telomere repeats onto chromosomal ends and maintains telomere length. Telomerase activity has been detected in a broad range of human malignant neoplasms, but not in normal somatic cells. So, activation of telomerase may represent an essential step in the malignant transformation of cells. However, the expression of telomerase in premalignant lesions remains relatively unexplored. This study was conducted to investigate the reactivation of telomerase in the carcinogenesis of human breast tissue.
METHODS
In situ hybridization for the telomerase RNA component (human telomerase mRNA; hTR) was used in a normal breast tissue (n=41), florid ductal hyperplasia (FDH) (n=10), atypical ductal hyperplasia (ADH) (n=3), ductal carcinoma in situ (DCIS) (n=44) and invasive carcinoma (n=33). hTR expression in relation to p53 status and the pathologic parameters in breast cancer was also studied.
RESULTS
Expression of hTR was demonstrated in 13 samples (31.7%) of normal breast tissues, 4 (40%) of FDH, 3 (100%) of ADH, 42 (95.5%) of DCIS, and 33 (100%) of invasive carcinoma. The rate of hTR expression of ADH was significantly different from that of FDH (p<0.05), and there were no differences in hTR expression rates among ADH, DCIS and invasive carcinomas. There was no correlation between hTR expression and nuclear grade, tumor size, and p53 status in invasive carcinomas.
CONCLUSION
These results suggest that telomerase activation may be an early event and an essential step in the carcinogenesis of human breast tissue, and that telomerase has no correlations with p53 status and prognostic parameters.

A Clinicopathologic Study of 53 Gastrointestinal Mesenchymal Tumors.: Young Kyung Bae, Dong Sug Kim, Mi Jin Gu, Joon Hyuk Choi, Mi Jin Kim, Young Jin Kim, Won Hee Choi, Sun Kyo Song, Koing Bo Kwun; Korean J Pathol. 2000;34(11):909-918.

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Abstract PDF: The gastrointestinal mesenchymal tumors (GIMTs) form a heterogenous group with controversy centering on both the cell of origin and the prediction of clinical behavior. They include a small group of tumors with mature smooth muscle or Schwann cell differentiation and a larger group with inconsistent or no evidence of differentiation. Tumors in the latter are now referred to as gastrointestinal stromal tumors (GISTs). A clinicopathologic and immunohistochemical study was performed on 53 cases of GIMTs to identify cellular differentiation and predictors of clinical behavior. Fifty three cases of GIMTs could be histologically and immunophenotypically divided into three categories, 6 leiomyomas (11.3%), 4 schwannomas (7.6%), and 43 GISTs (81.1%). All leiomyomas (SMA desmin ) and schwannomas (S-100 ) were located in stomach and negative for CD34 and CD117. Thirty nine cases of GISTs were either CD34 (n=26) or CD117 (n=23) immunoreactive. Of these 39 GISTs, 26 were negative for myoid (SMA, desmin) and neural marker (S-100), 10 SMA desmin-S-100-, two SMA-desmin-S-100 , and one SMA desmin-S-100 . Two out of 4 GISTs, which were negative for CD34 and CD117, were immunohistochemically considered leiomyosarcoma (SMA desmin ). GISTs of small intestine had a tendency to be malignant than those of stomach. Pathologic grade of GISTs was not correlated with cellular differentiation. In 29 GISTs with clinical follow-up information, tumor size, mitotic counts, Ki-67 labelling index, tumor necrosis, mucosal invasion, and CD34 expression were significantly correlated with metastasis/recurrence.

Imprint Cytologic Feature of Extraskeletal Osteosarcoma: A Case Report.: Mi Jin Gu, Young Kyung Bae, Mi Jin Kim, Joon Hyuk Choi, Won Hee Choi; Korean J Cytopathol. 2000;11(1):59-63.

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Abstract PDF: Extraskeletal osteosarcoma is an uncommon tumor originated from soft tissue without evidence of skeletal involvement. It usually affects adults and its common locations are extremity, buttock, and retroperitoneum. Although the histologic feature of this tumor is well known, there have been few reports on the fine needle aspiration cytologic findings. We report the imprint cytologic feature of extraskeletal osteosarcoma. The patient was a 49-year-old man with a mass of the left anterior chest for 2 years. On the imprint preparation, the smears showed malignant round, polygonal or spindle cells with coarsely clumped chromatin and occasionally prominent nucleoli. The malignant cells occur singly, in clusters, or associated with amorphous eosinophilic osteoid. Mitotic figures are also seen.

Angiosarcoma of the Uterus: A case report.: Young Kyung Bae, Joon Hyuk Choi, Mi Jin Kim; Korean J Pathol. 1999;33(7):521-524.

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Abstract PDF: Primary angiosarcoma of the female reproductive system is extremely rare, and its management is not well understood. We experienced a very rare case of angiosarcoma arising in the uterus of a 37-year-old woman who presented abdominal distension. At laparotomy, the uterus was observed to be enlarged and deformed by multilobulated hemorrhagic mass. Tumor deposits were present on both ovaries and the omentum. The operation consisted of total abdominal hysterectomy with salpingo-oophorectomy, and omentectomy. Microscopic examination showed that the tumor consisted mostly of solid sheets of pleomorphic and spindle cells forming irregular, communicating cleft-like spaces. Well-formed vascular channels lined by atypical endothelial cells were seen in differentiated areas. Some vessels were partially lined by normal endothelial cells and partially by neoplastic endothelial cells. Papillary architecture composed of epithelioid tumor cells was noted in a focal area. The tumor cells were immunoreactive for factor VIII-related antigen, Ulex europaeus agglutinin-1, CD31 and CD34. Weibel-Palade bodies were not seen in the tumor cells. She received adjuvant chemotherapy, but died 13 months after the diagnosis.

Combined Epithelial-Myoepithelial Carcinoma and Basal Cell Adenocarcinoma of the Parotid Gland: A case report.: Young Kyung Bae, Dong Sug Kim, Jang Soo Suh, Jae Yun Ro; Korean J Pathol. 1999;33(6):453-456.

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Abstract PDF: Epithelial-myoepithelial carcinoma and basal cell adenocarcinoma are uncommon, low-grade malignant epithelial neoplasms of salivary gland. They occur predominantly in the parotid glands with frequent recurrences and occasional distant metastases. We report an unusual case of combined epithelial-myoepithelial carcinoma and basal cell adenocarcinoma within the same mass of the parotid gland in a 32-year-old woman. To the best of our knowledge, this is the first such a combined carcinoma case.

Invasive Micropapillary Carcinoma of the Breast: A clinicopathologic study of 16 cases.: Young Kyung Bae, Dong Sug Kim, Mi Jin Kim, Soo Jung Lee; Korean J Pathol. 1999;33(4):267-273.

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Abstract PDF: Invasive micropapillary carcinoma is a recently defined unusual variant of invasive breast carcinoma characterized by the formation of micropapillae within clear spaces separated by delicate fibrocollagenous stroma. This study was designed to examine clinicopathologic features of invasive micropapillary carcinoma of the breast. Sixteen cases of invasive micropapillary carcinoma were retrieved from the files of the Department of Pathology, Yeungnam University College of Medicine. We evaluated their clinicopathologic findings including patients' age, tumor size, nuclear grade, vascular invasion, axillary lymph node status, presence of extensive intraductal carcinoma, estrogen and progesterone receptors, p53, c-erbB-2, MIB-1 labelling index and follow-up data and compared this results with those of 292 cases of invasive ductal carcinoma, not otherwise specified. The incidence of invasive micropapillary carcinoma was 4.2% of all invasive breast carcinoma, and the mean age of the patients was 46 years. Nine cases were pure form (over 75% of micropapillary growth pattern in the tumor) and seven cases were mixed form. The results of clinicopathologic findings, except vascular invasion and axillary lymph node status, of the 16 cases of invasive micropapillary carcinoma were not different from those of the 292 cases of invasive ductal carcinoma, not otherwise specified (p>0.05). However, the rate of vascular invasion and axillary lymph node metastasis was significantly higher in invasive micropapillary carcinoma (p <0.05). Of 16 cases, five cases had distant metastasis during follow-up period, and one patient died of cancer. Although the mechanism of higher vascular invasion and lymph node metastasis in micropapillary growth pattern could not be determined, we propose that invasive micropapillary carcinoma should be recognized as a separate entity with increased risks of vascular invasion and axillary lymph node metastsis.

Fine Needle Aspiration Cytology of Pigmented Villonodular Synovitis: A Case Report .: Joon Hyuk Choi, Young Kyung Bae, Young Ran Shim, Mi Jin Kim, Won Hee Choi; Korean J Cytopathol. 1999;10(2):191-195.

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Abstract PDF: Pigmented villonodular synovitis is a destructive, fibrohistiocytic proliferation producing innumerable villous and nodular synovial protrusions. Its common locations are knee, ankle, foot, and hip. Although histologic feature of this tumor is well known, there have been few reports on the fine needle aspiration cytology findings. We report the cytologic features of a biopsy-proven case of pigmented villonodular synovitis. The patient was a 21-year-old male with a mass of the right knee for 2 years. On fine needle aspiration cytology, the aspirates was composed of abundant mononuclear histiocytic cells, singly and in clusters, multinucleated giant cells, and hemosiderin pigments.

The Significance of Nuclear Size in Nuclear Grade of Invasive Ductal Carcinoma of the Breast.: Young Kyung Bae, Dong Sug Kim, Hye Jung Choi, Mi Jin Gu, Soo Jung Lee, Jea Young Lee; Korean J Cytopathol. 1999;10(1):21-26.

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Abstract PDF: To make the objective standard of nuclear size in grading nuclear pleomorphism of invasive ductal carcinoma of the breast, we measured maximal nuclear diameter of tumor cells on imprint cytology slides and histologic sections from 65 cases by using computer-based image analysis system(Optimas 6.0). The maximal diameter of red blood cells were also measured to evaluate the ratio of maximal nuclear diameter of tumor cells to maximal diameter of red blood cells. The mean values of maximal nuclear diameter of tumor cells on imprint cytology slides and histologic sections were 7.56 micrometer, 7.53 micrometer in nuclear grade 1, 8.92+/-0.98 micrometer, 9.02+/-0.74 micrometer in nuclear grade 2, and 12.90+/-1.47 micrometer, 12.44+/-1.41 micrometer in nuclear grade 3, respectively. There were no significant differences between values of imprint cytology and histologic section. The ratio of maximal nuclear diameter of tumor cells to maximal diameter of red blood cells were 1.3-1.4:1 in nuclear grade 1, 1.6-1.7:1 in nuclear grade 2, and 2.2-2.3:1 in nuclear grade 3. These values would be guidelines for grading nuclear pleomorphism of invasive ductal carcinoma of the breast on routine surgical pathology work.

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