Journal of Pathology and Translational Medicine

Eun Kyung Kim

9 Articles

A multicenter study of interobserver variability in pathologic diagnosis of papillary breast lesions on core needle biopsy with WHO classification: Hye Ju Kang, Sun Young Kwon, Ahrong Kim, Woo Gyeong Kim, Eun Kyung Kim, Ae Ree Kim, Chungyeul Kim, Soo Kee Min, So Young Park, Sun Hee Sung, Hye Kyoung Yoon, Ahwon Lee, Ji Shin Lee, Hyang Im Lee, Ho Chang Lee, Sung Chul Lim, Sun Young Jun, Min Jung Jung, Chang Won Jung, Soo Youn Cho, Eun Yoon Cho, Hye Jeong Choi, So Yeon Park, Jee Yeon Kim, In Ae Park, Youngmee Kwon; J Pathol Transl Med. 2021;55(6):380-387. Published online October 6, 2021; DOI: https://doi.org/10.4132/jptm.2021.07.29

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Background
Papillary breast lesions (PBLs) comprise diverse entities from benign and atypical lesions to malignant tumors. Although PBLs are characterized by a papillary growth pattern, it is challenging to achieve high diagnostic accuracy and reproducibility. Thus, we investigated the diagnostic reproducibility of PBLs in core needle biopsy (CNB) specimens with World Health Organization (WHO) classification.
Methods
Diagnostic reproducibility was assessed using interobserver variability (kappa value, κ) and agreement rate in the pathologic diagnosis of 60 PBL cases on CNB among 20 breast pathologists affiliated with 20 medical institutions in Korea. This analysis was performed using hematoxylin and eosin (H&E) staining and immunohistochemical (IHC) staining for cytokeratin 5 (CK5) and p63. The pathologic diagnosis of PBLs was based on WHO classification, which was used to establish simple classifications (4-tier, 3-tier, and 2-tier).
Results
On WHO classification, H&E staining exhibited ‘fair agreement’ (κ = 0.21) with a 47.0% agreement rate. Simple classifications presented improvement in interobserver variability and agreement rate. IHC staining increased the kappa value and agreement rate in all the classifications. Despite IHC staining, the encapsulated/solid papillary carcinoma (EPC/SPC) subgroup (κ = 0.16) exhibited lower agreement compared to the non-EPC/SPC subgroup (κ = 0.35) with WHO classification, which was similar to the results of any other classification systems.
Conclusions
Although the use of IHC staining for CK5 and p63 increased the diagnostic agreement of PBLs in CNB specimens, WHO classification exhibited a higher discordance rate compared to any other classifications. Therefore, this result warrants further intensive consensus studies to improve the diagnostic reproducibility of PBLs with WHO classification.

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Invasive papillary carcinoma of the breast
Shijing Wang, Qingfu Zhang, Xiaoyun Mao
Frontiers in Oncology.2024;[Epub] CrossRef
Encapsulated papillary carcinoma of the breast: A single institution experience
Liang Xu, Qixin Mao, Qiuming Liu, Yufeng Gao, Lihua Luo, Chungen Guo, Wei Qu, Ningning Yan, Yali Cao
Oncology Letters.2023;[Epub] CrossRef
High-risk and selected benign breast lesions diagnosed on core needle biopsy: Evidence for and against immediate surgical excision
Aparna Harbhajanka, Hannah L. Gilmore, Benjamin C. Calhoun
Modern Pathology.2022; 35(11): 1500. CrossRef

Standardized pathology report for breast cancer: Soo Youn Cho, So Yeon Park, Young Kyung Bae, Jee Yeon Kim, Eun Kyung Kim, Woo Gyeong Kim, Youngmee Kwon, Ahwon Lee, Hee Jin Lee, Ji Shin Lee, Jee Young Park, Gyungyub Gong, Hye Kyoung Yoon; J Pathol Transl Med. 2021;55(1):1-15. Published online January 11, 2021; DOI: https://doi.org/10.4132/jptm.2020.11.20

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Abstract PDF Supplementary Material

Given the recent advances in management and understanding of breast cancer, a standardized pathology report reflecting these changes is critical. To meet this need, the Breast Pathology Study Group of the Korean Society of Pathologists has developed a standardized pathology reporting format for breast cancer, consisting of ‘standard data elements,’ ‘conditional data elements,’ and a biomarker report form. The ‘standard data elements’ consist of the basic pathologic features used for prognostication, while other factors related to prognosis or diagnosis are described in the ‘conditional data elements.’ In addition to standard data elements, all recommended issues are also presented. We expect that this standardized pathology report for breast cancer will improve diagnostic concordance and communication between pathologists and clinicians, as well as between pathologists inter-institutionally.

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Residual pure intralymphatic carcinoma component only (lymphovascular tumor emboli without invasive carcinoma) after neoadjuvant chemotherapy is associated with poor outcome: Not pathologic complete response
Hyunwoo Lee, Yunjeong Jang, Yoon Ah Cho, Eun Yoon Cho
Human Pathology.2024; 145: 1. CrossRef
Sentinel lymph node biopsy in patients with ductal carcinomain situ: systematic review and meta-analysis
Matthew G. Davey, Colm O’Flaherty, Eoin F. Cleere, Aoife Nohilly, James Phelan, Evan Ronane, Aoife J. Lowery, Michael J. Kerin
BJS Open.2022;[Epub] CrossRef

Merkel Cell Carcinoma Metastatic to Pleural Fluid: A Case Report: Ye-Young Rhee, Soo Hee Kim, Eun Kyung Kim, Se Hoon Kim; J Pathol Transl Med. 2018;52(3):206-209. Published online November 23, 2017; DOI: https://doi.org/10.4132/jptm.2017.11.10

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Abstract PDF

Merkel cell carcinoma (MCC) is a rare aggressive neuroendocrine carcinoma of the skin that shows locoregional or distant metastasis. Metastasis of MCC to body cavity effusion is extremely rare; only three cases have been reported so far. Metastatic MCC in effusion cytology shows small blue round cells with fine stippled chromatin like other small blue round cell tumors such as small cell lung carcinoma or lymphoma. The diagnosis of metastatic MCC can grant patients good chances at recently advanced therapeutic options. Here, we present a case of metastatic MCC to pleural effusion with characteristic single file-like pattern.

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Merkel cell carcinoma presenting as a malignant pleural effusion post‐COVID‐19 hospitalization: A case report and literature review
Joel Lanceta, Mesut Toprak, Oana C. Rosca
Diagnostic Cytopathology.2022;[Epub] CrossRef
Cytology coupled with immunocytochemistry identifies Merkel cell carcinoma: A rare intruder in the cerebrospinal fluid
Reetu Kundu, Brijdeep Singh, Pranab Dey
Cytopathology.2022; 33(4): 530. CrossRef
Derrame pleural por carcinoma de células de Merkel
María J. Soler-Sempere, María O. Alvárez-Fernández, Isabel Padilla-Navas, María Cabezas-Macián, Jose F. Sánchez-Hernández, Eduardo García-Pachón
Archivos de Bronconeumología.2021; 57(11): 715. CrossRef
A rare case of pleural localisation of both metastatic Merkel cell carcinoma and chronic lymphocytic leukaemia
Elise Kaspi, Shirley Fritz, Julien Colle, Florent Amatore, Diane Frankel, Patrice Roll
Cytopathology.2021; 32(3): 367. CrossRef
Merkel cell carcinoma with pleural effusion
María J. Soler-Sempere, María O. Alvárez-Fernández, Isabel Padilla-Navas, María Cabezas-Macián, Jose F. Sánchez-Hernández, Eduardo García-Pachón
Archivos de Bronconeumología (English Edition).2021; 57(11): 715. CrossRef

Comparison of Unsatisfactory Samples from Conventional Smear versus Liquid-Based Cytology in Uterine Cervical Cancer Screening Test: Hoiseon Jeong, Sung Ran Hong, Seoung-Wan Chae, So-Young Jin, Hye Kyoung Yoon, Juhie Lee, Eun Kyung Kim, Sook Tai Ha, Sung Nam Kim, Eun-Jung Park, Jong Jae Jung, Sun Hee Sung, Sung-chul Lim; J Pathol Transl Med. 2017;51(3):314-319. Published online April 17, 2017; DOI: https://doi.org/10.4132/jptm.2017.03.17

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Abstract PDF

Background
Cervical cytology for uterine cervical cancer screening has transitioned from conventional smear (CS) to liquid-based cytology (LBC), which has many advantages. The aim of this study was to compare the proportion of unsatisfactory specimens from CS versus LBC at multiple institutions including general hospitals and commercial laboratories.
Methods
Each participating institution provided a minimum of 500 Papanicolaou (Pap) test results for analysis. Pap tests were classified according to the participating institution (commercial laboratory or general hospital) and the processing method (CS, ThinPrep, SurePath, or CellPrep). The causes of unsatisfactory results were classified as technical problems, scant cellularity, or complete obscuring factors.
Results
A total of 38,956 Pap test results from eight general hospitals and three commercial laboratories were analyzed. The mean unsatisfactory rate of LBC was significantly lower than that of CS (1.26% and 3.31%, p = .018). In the LBC method, samples from general hospitals had lower unsatisfactory rates than those from commercial laboratories (0.65% vs 2.89%, p = .006). The reasons for unsatisfactory results were heterogeneous in CS. On the other hand, 66.2% of unsatisfactory results in LBC were due to the scant cellularity.
Conclusions
Unsatisfactory rate of cervical cancer screening test results varies according to the institution and the processing method. LBC has a significantly lower unsatisfactory rate than CS.

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The possibilities of adapting the re-processing protocol in the practice of the ThinPrep Pap test usage
Artem K. Aksamentov, Nadezhda V. Melnikova, Eugenia V. Moshnina, Nadezhda A. Kolyshkina, Olga N. Kucherova, Vladimir P. Baklaushev
Journal of Clinical Practice.2023; 14(1): 108. CrossRef
The Role of p16/Ki67 Dual Staining in Cervical Cancer Screening
Andraž Dovnik, Alenka Repše Fokter
Current Issues in Molecular Biology.2023; 45(10): 8476. CrossRef
Evaluation of a Novel Fixative Solution for Liquid-Based Cytology in Diagnostic Cytopathology
Nadia Casatta, Alessia Poli, Sara Bassani, Gianna Veronesi, Giulio Rossi, Clarissa Ferrari, Carmelo Lupo
Diagnostics.2023; 13(24): 3601. CrossRef
Liquid-Based cytology in the detection of premalignant lesions in patients with “atypia in squamous cells” in conventional cytology
Lia Barrios, Yoled Vizcaíno, Ines Benedetti
Journal of Cytology.2022; 39(4): 148. CrossRef
Meeting the challenges of cervical cancer screening and HPV vaccination in the UK
Roxanne Westwood, Joanna Lavery
Primary Health Care.2022; 32(01): 22. CrossRef
Method for preservation of DNA stability of liquid-based cytology specimens from a lung adenocarcinoma cell line
Yukiko Matsuo, Kazuya Yamashita, Tsutomu Yoshida, Yukitoshi Satoh
Virchows Archiv.2021; 478(3): 507. CrossRef
High-risk human papillomavirus test in anal smears: can it optimize the screening for anal cancer?
Cintia M.S. Kimura, Caio S.R. Nahas, Edésio V. Silva-Filho, Vinícius L. Ribeiro, Aluisio C. Segurado, Flávio F.P. Alcântara, Ivan Cecconello, Sergio C. Nahas
AIDS.2021; 35(5): 737. CrossRef
Automatic model for cervical cancer screening based on convolutional neural network: a retrospective, multicohort, multicenter study
Xiangyu Tan, Kexin Li, Jiucheng Zhang, Wenzhe Wang, Bian Wu, Jian Wu, Xiaoping Li, Xiaoyuan Huang
Cancer Cell International.2021;[Epub] CrossRef
The cytological component of cervical cancer screening: causes of false negative and false positive results, and ways to avoid them
O.A. Burka, N.F. Lygyrda, V.V. Kutsovol, A.V. Svintsitska
REPRODUCTIVE ENDOCRINOLOGY.2021; (57): 61. CrossRef
Comparison of liquid-based cytology with conventional smear cytology for EUS-guided FNA of solid pancreatic masses: a prospective randomized noninferiority study
Jung Won Chun, Kyoungbun Lee, Sang Hyub Lee, Haeryoung Kim, Min Su You, Yoon Jung Hwang, Woo Hyun Paik, Ji Kon Ryu, Yong-Tae Kim
Gastrointestinal Endoscopy.2020; 91(4): 837. CrossRef
Effective reduction in inadequate Pap smears by using a saline-lubricated speculum and two glass slides
Chi-Jui Chen, Mun-Kun Hong, Dah-Ching Ding
Taiwanese Journal of Obstetrics and Gynecology.2020; 59(6): 906. CrossRef
Characterizing the Effect of Automated Cell Sorting Solutions on Cytomorphological Changes
Katsuhide Ikeda, Shouichi Sato, Hiroshi Chigira, Yasuo Shibuki, Nobuyoshi Hiraoka
Acta Cytologica.2020; 64(3): 232. CrossRef
Comparison between Conventional Cytology and Liquid-Based Cytology in the Tertiary Brazilian Navy Hospital in Rio de Janeiro
Antônio Carlos Almeida de Oliveira, Miguel Fontes Domingues, Paulo Murilo Neufeld, Marcos Fleury, José Firmino Nogueira Neto
Acta Cytologica.2020; 64(6): 539. CrossRef
Follow‐up with histopathology and HPV testing on LSIL cytology in China’s largest academic woman’s hospital
Xiang Tao, Huina Zhang, Hao Zhang, Jianan Xiao, Juan Li, Xianrong Zhou, Li Wang, Chengquan Zhao
Cancer Cytopathology.2019; 127(4): 258. CrossRef
Current Status of and Perspectives on Cervical Cancer Screening in Korea
Sung-Chul Lim, Chong Woo Yoo
Journal of Pathology and Translational Medicine.2019; 53(4): 210. CrossRef
Reducing DNA damage by formaldehyde in liquid‐based cytology preservation solutions to enable the molecular testing of lung cancer specimens
Yukiko Matsuo, Tsutomu Yoshida, Kazuya Yamashita, Yukitoshi Satoh
Cancer Cytopathology.2018; 126(12): 1011. CrossRef
Cervical Cancer Screening Programs in Europe: The Transition Towards HPV Vaccination and Population-Based HPV Testing
Andreas Chrysostomou, Dora Stylianou, Anastasia Constantinidou, Leondios Kostrikis
Viruses.2018; 10(12): 729. CrossRef

Mucinous Carcinoma with Extensive Signet Ring Cell Differentiation: A Case Report: Hye Min Kim, Eun Kyung Kim, Ja Seung Koo; J Pathol Transl Med. 2017;51(2):176-179. Published online December 5, 2016; DOI: https://doi.org/10.4132/jptm.2016.08.17

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Abstract PDF

Breast cancers that present with mucin include mucinous carcinoma and carcinoma with signet ring cell differentiation. The former shows extracellular mucin and the latter shows abundant intracellular mucin. Here, we report a case of breast cancer showing both extracellular mucin and extensive signet ring cell differentiation due to abundant intracellular mucin. Unlike mucinous carcinoma, this case had the features of high-grade nuclear pleomorphism, high mitotic index, estrogen receptor negativity, progesterone receptor negativity, human epidermal growth factor receptor-2 positivity, and ductal type with positivity for E-cadherin. In a case with signet ring cell differentiation, differential diagnosis with metastatic signet ring cell carcinoma of the stomach and colon is essential. In this case, the presence of accompanied ductal carcinoma in situ component and mammaglobin and gross cystic disease fluid protein-15 positivity were findings that suggested the breast as the origin.

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Research on the Histological Features and Pathological Types of Gastric Adenocarcinoma With Mucinous Differentiation
Nian-Long Meng, Yang-kun Wang, Hai-Li Wang, Jun-Ling Zhou, Su-nan Wang
Frontiers in Medicine.2022;[Epub] CrossRef
Clinicopathologic characteristics of HER2-positive pure mucinous carcinoma of the breast
Yunjeong Jang, Hera Jung, Han-Na Kim, Youjeong Seo, Emad Alsharif, Seok Jin Nam, Seok Won Kim, Jeong Eon Lee, Yeon Hee Park, Eun Yoon Cho, Soo Youn Cho
Journal of Pathology and Translational Medicine.2020; 54(1): 95. CrossRef
Human Epidermal Growth Factor Receptor 2-positive Mucinous Carcinoma with Signet Ring Cell Differentiation, Which Showed Complete Response after Neoadjuvant Chemotherapy
Yunjeong Jang, Eun Yoon Cho, Soo Youn Cho
Journal of Breast Cancer.2019; 22(2): 336. CrossRef

Soft Tissue Roasi-Dorfman Disease with Features of IgG4-Related Disease in a Patient with a History of Acute Myeloid Leukemia: Cheol Keun Park, Eun Kyung Kim, Ji-Ye Kim, Hayoung Woo, Mi Jang, Hyang Sook Jeong, Woo Ick Yang, Sang Kyum Kim; J Pathol Transl Med. 2016;50(3):246-249. Published online November 17, 2015; DOI: https://doi.org/10.4132/jptm.2015.10.08

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Upregulated Neuro-oncological Ventral Antigen 1 (NOVA1) Expression Is Specific to Mature and Immature T- and NK-Cell Lymphomas: Eun Kyung Kim, Sun Och Yoon, Soo Hee Kim, Woo Ick Yang, Yoon Ah Cho, Soo Jeong Kim; J Pathol Transl Med. 2016;50(2):104-112. Published online February 29, 2016; DOI: https://doi.org/10.4132/jptm.2016.02.08

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Abstract PDF

Background
Recent studies have revealed that the splicing factor neuro-oncological ventral antigen 1 (NOVA1) is enriched in fibroblasts and accumulated T cells of tertiary lymphoid structures. In the present study, we investigated NOVA1 expression in various subtypes of mature and immature T- and natural killer (NK)-cell lymphomas as well as in various B-cell lymphoma subtypes. Methods: NOVA1 immunoexpression was evaluated in hyperplastic palatine tonsils (n = 20), T- and NK-cell lymphomas (n = 177), diffuse large B-cell lymphomas (n = 151), and other types of B cell lymphomas (n = 31). Nuclear staining intensity and percentage of positive tumor cells were graded. NOVA1 mRNA expression was analyzed in various lymphoma cell lines. Results: Tumor cells of T- and NK-cell lymphomas showed higher expression levels of NOVA1 than did normal paracortical T cells, and 56.5% of T- and NK-cell lymphoma cases showed diffuse and strong expression. The NOVA1 expression level varied according to the subtype; it was higher in angioimmunoblastic T-cell lymphoma, anaplastic lymphoma kinase (ALK)-negative anaplastic large cell lymphoma (ALCL), and T lymphoblastic leukemia/lymphoma (T-LBL), but it was lower in ALK-positive ALCL. In almost all B-cell lymphomas, NOVA1 expression was very low or negative. NOVA1 mRNA was also expressed in Jurkat, a T-LBL cell line. Conclusions: The present findings suggest that NOVA1 upregulation may be involved in certain subtypes of T- and NK-cell lymphomas, but not in B-cell lymphomas. Upregulated NOVA1 expression seems to be a specific biological feature of activated T cells such as T- and NK-cell lymphomas.

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Intraoperative pathologic diagnosis of central nervous system lymphomas: A comparison of frozen and permanent section diagnoses, and the significance of preoperative imaging
Aslı Kahraman, Fikret Dirilenoğlu, İsmail Güzeliş, Kenan Çetinoğlu
Annals of Diagnostic Pathology.2024; 69: 152246. CrossRef
NOVA1 acts on Impact to regulate hypothalamic function and translation in inhibitory neurons
Yoko Tajima, Keiichi Ito, Yuan Yuan, Mayu O. Frank, Yuhki Saito, Robert B. Darnell
Cell Reports.2023; 42(2): 112050. CrossRef
MicroRNA miR-27a-3p accelerates cardiac hypertrophy by targeting neuro-oncological ventral antigen 1
Dongyun Li, Mingzhi Shen, Xinxin Deng, Yongyi Bai
Bioengineered.2022; 13(4): 8982. CrossRef
NOVA1 promotes NSCLC proliferation and invasion by activating Wnt/β-catenin signaling
Lianyue Qu, Yulong Tian, Fan Wang, Zixuan Li
BMC Cancer.2022;[Epub] CrossRef
Identification of the Functions and Prognostic Values of RNA Binding Proteins in Bladder Cancer
Yue Wu, Zheng Liu, Xian Wei, Huan Feng, Bintao Hu, Bo Liu, Yang Luan, Yajun Ruan, Xiaming Liu, Zhuo Liu, Shaogang Wang, Jihong Liu, Tao Wang
Frontiers in Genetics.2021;[Epub] CrossRef
Nervous system and gastric cancer
Ke Wang, Xin-hui Zhao, Jun Liu, Rui Zhang, Ji-peng Li
Biochimica et Biophysica Acta (BBA) - Reviews on Cancer.2020; 1873(1): 188313. CrossRef
The RNA-binding protein RBM47 inhibits non-small cell lung carcinoma metastasis through modulation of AXIN1 mRNA stability and Wnt/β-catentin signaling
Di-jian Shen, You-hua Jiang, Jian-qiang Li, Li-wei Xu, Kai-yi Tao
Surgical Oncology.2020; 34: 31. CrossRef
Genome-Wide Profiling of Cervical RNA-Binding Proteins Identifies Human Papillomavirus Regulation of RNASEH2A Expression by Viral E7 and E2F1
Junfen Xu, Habin Liu, Yanqin Yang, Xiaohong Wang, Poching Liu, Yang Li, Craig Meyers, Nilam Sanjib Banerjee, Hsu-Kun Wang, Maggie Cam, Weiguo Lu, Louise T. Chow, Xing Xie, Jun Zhu, Zhi-Ming Zheng, Xiang-Jin Meng, James Pipas, Xuefeng Liu, Lucia Pirisi-cre
mBio.2019;[Epub] CrossRef
NOVA1 induction by inflammation and NOVA1 suppression by epigenetic regulation in head and neck squamous cell carcinoma
Eun Kyung Kim, Yoon Ah Cho, Mi-kyoung Seo, Hyunmi Ryu, Byoung Chul Cho, Yoon Woo Koh, Sun Och Yoon
Scientific Reports.2019;[Epub] CrossRef
The RNA binding protein neuro‐oncological ventral antigen 1 (NOVA1) regulates IL-6 mRNA stability to enhance JAK2-STAT3 signaling in CRC
Yong-gang Hong, Guo-shu Xu, Guan-yu Yu, Ji-dian Zhou, Qi-zhi Liu, Jun-sheng Ni, Hong-li Yan, Wei Zhang, Li-qiang Hao
Surgical Oncology.2019; 31: 67. CrossRef
NOVA1 acts as an oncogene in melanoma via regulating FOXO3a expression
Xin Yu, Heyi Zheng, Matthew T.V. Chan, William K.K. Wu
Journal of Cellular and Molecular Medicine.2018; 22(5): 2622. CrossRef
Neuro‐oncological ventral antigen 1 (NOVA1): Implications in neurological diseases and cancers
Yu Xin, Zheng Li, Heyi Zheng, Jeffery Ho, Matthew T. V. Chan, William K. K. Wu
Cell Proliferation.2017;[Epub] CrossRef
New developments in the pathology of malignant lymphoma. A review of the literature published from January–April 2016
J. Han van Krieken
Journal of Hematopathology.2016; 9(2): 73. CrossRef

Ureteral Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue, Chronic Inflammation, and Renal Artery Atherosclerosis: Hojung Lee, Jong Eun Joo, Young Ok Hong, Won Mi Lee, Eun Kyung Kim, Jeong Joo Woo, Soo Jung Gong, Jooryung Huh; J Pathol Transl Med. 2015;49(4):339-342. Published online June 1, 2015; DOI: https://doi.org/10.4132/jptm.2015.04.28

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Spindle Cell Rhabdomyosacoma of Uterus: A Case Study: Dae Woon Kim, Jung Hwan Shin, Ho Jung Lee, Young Ok Hong, Jong Eun Joo, Eun Kyung Kim; Korean J Pathol. 2013;47(4):388-391. Published online August 26, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.4.388

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Abstract PDF

Uterine rhabdomyosarcoma (RMS) typically presents as a mixed epithelial and mesenchymal tumors. Pure RMSs of the female genital tract are uncommon. Spindle cell variant of RMS is a rare morphologic subtype of embryonal RMS and mostly occurs in the paratesticular region of children. Here, we present a case of uterine spindle cell RMS in a 76-year-old woman. The tumor, 20×15×7 cm in size, was highly necrotic and adherent to the colon and rectum. Tumor cells were mostly spindle-shaped, and isolated rhabdomyoblasts were scattered. Immunohistochemical stains for myoglobin and myo-D1 showed diffuse positivity for tumor cells. The patient died only of disease three months after diagnosis.

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