Journal of Pathology and Translational Medicine

Morphologic Studies on the Endometrium of Abnormal Uterine Bleeding with Special Emphasis on Dysfunctional Uterine Bleeding: Young Hyeh Koh, Chan Il Park, In Joon Choi, Yoo Bock Lee; J Pathol Transl Med. 1983;17(1):1-9.

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Abstract: Abnormal uterine bleeding is one of the most common symptoms in gynecologic disorders of which dysfunctional uterine bleeding (DUB) is frequently encountered. Although the correct diagnosis of DUB relies on various assessments such as the menstrual cycle, basal body temperature, endocrine assay, vaginal cytology and endometrial histologic findings, pathologists have been encountered in many instances which have to make a diagnosis on the endometrium only. In view of great difficulties to make a proper histologic evaluation of endometrium in cases of DUB, the present study is undertaken to asses the pattern of the endometrium in DUB among Koreans. The material consisted of 123 cases of endometrial curettage specimens diagnosed as DUB, among which 17 cases were subjected to total hysterectomy. Histologic examination was carried out through routine formaline fixed-paraffin embedding methods followed by hematoxylin-eosin staining routinely and other special stainings as required. Histologic pattern of the endometrium was classified according to Handrickson and Kempson (1980) and clinical correlation was made. The following results were obtained: 1) The pattern of the endometrium in DUB was predominantly non-secretory type (77 cases) and the secretory type was observed in 46 cases. Abnormal endometrial histology was found in 73 cases of which 59 cases was non-secretory and 14 cases secretory type. 2) The incidence of anovulatory bleeding in DUB was 59%. 3) The bleeding pattern was mostly metrorrhagia but menometrorrhagia was predominant in cases of hyperplasia. 4) The incidence of recurrent bleeding was 31% and relatively higher in secretory endometrium.

A Histopathologic Study on Malignant Lymphoma among Koreans: Sung Sik Shin, Geung Hwan Ahn, Sang Kook Lee; J Pathol Transl Med. 1983;17(1):10-20.

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Abstract: A total of 160 cases of non-Hodgkin's lymphoma were obtained form the file of Department of Pathology, Seoul National University Hospital during a period of 5 years beginning from 1976 to 1980. These tumors were classified according to modified Rappaport and Lukes-Collins classifications. The patient ranged in age from 1 to 84 years, with an average of 36.9 years. One hundred and ten patients were male and 50 were female, and male-to-female ratio was 2.2 : 1. Of 160 cases, 5 cases (3.0%) were nodular lymphoma and 155(96.9%) were diffuse lymphoma. Nodular lymphomas consisted of 4 cases (2.5%) of histiocytic type and 1 case(0.6%) of mixed type. Diffuse lymphomas consisted of 93 cases (58.1%) of histiocytic type, 32 cases (20.0%) of poorly differentiated lymphocytic type, 16 cases (10.0%) of lymphoblastic type, 8 cases (5.0%) of mixed type, 3 cases (1.9%) of undifferentiatiated Burkitt type, 2 cases (1.3%) of undifferentiated pleomorphic type, and 1 case (0.6%) of mycosis fungoides. Cases of nodular poorly differentiated lymphocytic and diffuse well differentiated lymphocytic type were not found. Fourteen of 16 lymphoblastic lymphomas occurred under the age of 20. Nodular type was not present under the age of 20. Analysis of biopsy sites disclosed 69 cases (43.1%) from lymph node and 91 cases (56.9%) of extranoal sites. Most frequent extrandodal site was tonsil, followed by gastrointestinal tract, subcutaneous tissue, oral cavity, nasal cavity and nasopharynx. In summary, the low frequency of nodular lymphoma and extreme rarity (none in this series) of well differentiated lymphocytic lymphoma were confirmed and the most frequent type was diffuse histiocytic lymphoma. Detailed discussion of morphologic characteristics and comparison of Rappaport and Lukes-Colline classifications were done.

Influence of Specimen Evaporation to Chemical Analytical Values: J.H. Um, H.R. Park, K.E. Cheong, M.J. Cho; J Pathol Transl Med. 1983;17(1):21-25.

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Abstract: Serum sample, selected and control sera stored in various environment indicated, ie., refrigerating or room temperature, were analyzed to evaluate the effects of evaporation due to storing condition on sample weight and analytical values. The storage period choiced are 4 hours and the results analyzed are ase as follow: 1) The serum sample stored in room air revealed 13.39% decrease in weight and 7.1% decrease in refrigerator. 2) The analytical value of the serum sample and control sera stored in room air revealed obvious increase ie., 24.4～24.2% in SGOT., 16.6～29.4% in SGPT., 25.8～8.2% in Alk. phosphatase, 9.7～11.7% in total protein, 13.1～19.4% in albumin and 15.6～3.2% in cholesterol. The more striking alterations are noted in enzyme items of serum than in nen-enzyme than in non-enzyme items. 3) The serum and control sera sample stored in refrigerator revealed increased value of 9.8～10.3% in SGOT., 6.3～5.3% in SGPT., 1.1～2.5% in Alk. prosphatase, 2.7～1.5% in total protein, 5.2～4.5% in albumin and 3.0～5.0% in cholesterol. 4) It is, therefore, recommended that should be stored the serum samples in the refrigerator until tested which obviously alleviate the evaporative loss of weight and analytical variations.

A Comparative Study on the Value of Rheumatoid Factor Determined with Nephelometric and Latex Agglutination Methods: In Suck Song; J Pathol Transl Med. 1983;17(1):26-31.

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Abstract: The present study was done to compare the laser nephelometry with the latex agglutination test for the determination of rheumatoid factor. The following results were obtained. 1) The latex agglutination method was simple for qualitative tests but the nephelometry method was simpler and more accurate than the other for quantitative tests. 2) With the nephelometric method, endpoints were objectively assessed and standardization was easy. 3) In quantitative tests, the data were highly reproducible with the nephelometry method. 4) Both methods were generally similar in specificity and sensitivity but the nephelometry was more specific than the other in progressive and convalescent stages of the disease.

Prevalence of Methicillin-resistant Staphylococcus and the Antimicrobial Susceptibility: Kyng Sook Kim, Yunsop Chong, Oh Hun Kwon, Samuel Y. Lee; J Pathol Transl Med. 1983;17(1):32-37.

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Abstract: Although increasing incidence of infections with methicillin-resistant Staphylococcus aureus (MRSA) has been reported in other countries, the situation of our country is not clearly ascertained. S. aureus isolated from various clinical specimens at Yonsei Medical Center was tested for the antimicrobial susceptibility by the Kirby-Bauer method. The MRSA isolated in 1981 was tested for the antimicrobial susceptibility by agar dilution method. Following results were obtained. 1) Increased prevalence of MRSA from 0% to 31.7% was noted during the period of August 1979 to June 1982. 2) MRSA was isolated only from inpatients but not from outpatients. No difference was noted in the isolation rate by sources of specimen. 3) Cephalothin was the most active drug against MRSA, showing the lowest MIC range, MIC50 and MIC90. Among the MRSA isolates, 91.2% was susceptible to this drug. 4) To amikacin, 58.8% of the MRSA was susceptible while all were resistant to dibekacin, gentamicin, tobramycin. It is concluded from this study that infections due to MRSA is increasing among inpatients, and increasing difficulty is anticipated to control MRSA infection as the amikacin is the only active aminoglycoside.

Anaerobic Culture Results of Clinical Specimens and Antimicrobial Susceptibility of Bacteroides Isolates: Hee Joo Lee, Yunsop Chong, Samuel Y. Lee; J Pathol Transl Med. 1983;17(1):38-45.

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Abstract: In order to determine the recent trend of anaerobic bacteria isolation and the susceptibility of Bacteroides to antimicrobial agents, an analysis was made on the data of routine anaerobic cultures at Yonsei Medical Center during the period of September 1980 to August 1981. The following results were obtained. 1) A total of 336 isolates of anaerobic bacteria were obtained from various clinical specimens. Among the isolates 38.7% were gram-positive cocci and 53.3% were gram-negative bacilli. 2) Peptococcus magnus(20.3%) and P. asaccharolyticu(16.5%) were the frequently isolated gram-positive cocci and B. fragilis(70.4%) and B. thetaiotaomicron(15.1%) were the frequently isolated gram-negative bacilli. 3) Anaerobic bacteria were frequently isolated from specimens of abdomen and female genital tract. Peritonitis and intra-abdominal abscess were frequent clinical findings. 4) Among the anaerobe positive specimens, 22.4% yielded anaerobes alone while the remaining 77.6% also yielded aerobic bacteria. 5) Most of the B. fragilis and B. thetaiotaomicron isolates were susceptible to cefoxitin and chloramphenicol, but resistant to tetracycline.

Scanning Electron Microscopy of the Ultrastructure of Pancreatic Acinar Cells: Kun Young Kwon, Jyong Sik Kwak, Tae Joong Sohn; J Pathol Transl Med. 1983;17(1):46-52.

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Abstract: Several methods of tissue preparation and different modes of operation of the scanning electron microscope were used to study the ultrastructure of cells. The author examined ultrastructure of rat pancreatic acinar cells prepared by Osmium-DMSO-Osmium and subsequent cracked with razor blade, and discussed the scanning electron microscope images in comparison with light microscopic and transmission electron microscopic findings. The results were as follow. The ultrastructure of pancreatic acinar cells prepared by Osmium-DMSO-Osmium method was well exposed. The transmission electron microscopy easily revealed the cellular organelles which were poorly visualized by light microscope. The ultrastructures of pancreatic acinar cells studied by SEM were well correlated with results obtained by TEM. The surface of nuclear membrane was smooth. Mitochondria were round or elongated and had many cristae. RER arranged in lamellar pattern with occasional dilatation. Golgi complex was composed of vesicles, lamellae and vacuoles. The inner surfaces of above mentioned organelles revealed relatively granular textures. One important point revealed by cracked samples concerns the findings of spherical secretory granules within thin walled cavities, which suggestive of Golgi vesicle origin. These vesicles appear connected by small openings. It is suggested that they may represent a system of intercommunicating chambers(vacuoles).

Adenocarcinoma arising in Intrapulmonary Teratoma: Eun Kyung Hong, Jung Dal Lee, Seh Young Yuh*, Jae Kwon Chin*, Yup Yoon**; J Pathol Transl Med. 1983;17(1):53-59.

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Abstract: A rare case of malignant intrapulmonary teratoma is reported. The patient, 50 year old female, had suffered from symptoms characteristic of a benign intrapulmonary teratoma more than twenty years. After the confirmation on a bronchoscopic biopsy of adenocarcinoma arising in the pre-existing benign teratoma, left pneumonectomy was performed. The adenocarcinomatous component metastasized to the contralateral lung one year after the pneumonectomy, and the patient died in 3 months after the metastasis. The histogenesis, clinical behavior and pathologic features of intrapulmonary malignant teratoma are discussed, and the rarity of the pulmonary location of this lesion is emphasized.

Adenomatoid Tumor of the Fallopian Tube -Report of an unusually large cases-: Eun Duk Chang, Byung Kee Kim, Sun Moo Kim, Chong Moo Lee; J Pathol Transl Med. 1983;17(1):60-63.

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Abstract: The adenomatoid tumor is a rare benign neoplasm which is usually a small circumscribed lesion of the female and male genital tract characterized by adenomatous structure and it's histogenesis has been controversial. We experienced a case of an unusually large adenomatoid tumor of the fallopian tube in 54 year old female. Grossly, the tumor was firm and gray white to yellow and large(7㎝ in diameter), which found beneath the serosa in the isthmic portion of the fallopian tube. Microscopicall, the tumor consisted of irregular glands or vessel like spaces which were lined by flattened endothelial like cells or plump cuboidal cells. A brief review of the literature was made.

A Case of Large Cell Carcinoma of the Lung Associated with Idiopathic Interstitial Pulmonary Fibrosis: Min Chul Lee, In Sun Kim, Seung Yong Paik; J Pathol Transl Med. 1983;17(1):64-69.

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Abstract: The association of the carcinoma and diffuse interstitial fibrosis of the lung has been recognized. We experienced a case of diffuse interstitial fibrosis accompanied by peripheral carcinoma in lung of a 58 year-old male. Case report and brief literature review about its pathogenesis were done.

Ovotestis: Yoon Seong Lee, Chul Woo Kim, Sung Sik Shin, Je G. Ghi; J Pathol Transl Med. 1983;17(1):70-76.

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Abstract: 난소고환은 하나의 생식선에 고환의 조직과 난소 조직이 혼재하여 나타나는 비교적 드문 생식선의 발생 기형이다. 또한 난소고환의 존재로 바로 그 개체가 진성 반음양에 속하며, 다양한 외부 생식기 및 내생식기의 기형을 수반한다. 생식기의 기형으로 인한 반음양은 고대로부터 알려져 있으나 대부분의 예가 생식선은 단일의 성이나 다만 생식기의 발달이 모호한 가성 반음양의 경우이다. 따라서 진성 반음양은 더욱 드물며, 진성 반음양의 진단에는 반드시 조직학적 증거를 필요로 하게 되었다. 조직학적 증거와 생식선의 분포에 따라 진성 반음양은 ① 교환형 ② 양측형 및 ③ 단측형의 3가지 유형으로 구분하며 이미 수백 예의 진성 반음양이 보고되었다. 난소고환은 그 자체로 진성 반음양의 진단이 가능하며 대개 단측형에 속한다. 저자들은 서울대학교 의과대학 병리학 교실에서 3례의 난소고환을 경험하였기에 그들의 임상적, 병리학적 그리고 성염색체 검사 소견을 이미 국내의 문헌에 보고된 4례의 난소고환례와 비교하여 보고하는 바이다.

A Case of Retroperitoneal Malignant Mesenchymoma: Ho Kun Lee, Dae Yung Kang; J Pathol Transl Med. 1983;17(1):77-80.

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Abstract: Malignant mesenchymoma is a rare tumor formed by two or more unrelated mesenchymal tissues, disregarding the fibrous component that is usually present ot some extent. The tumor is found in all ages and locations, but most occur in the deeper structures of the extremities and in the retroperitoneum. The biologic behavior of the malignant mesenchymoma is characterized by rapid growing and, non responsiveness to all modes of therapy. We experienced a case of malignant mesenchymoma in 33 years old woman. Grossly, submitted specimen consists of a huge, capsulated tumor mass with attached kidney. The tumor mass measures 20×17×16㎝, and 1850gm in weight. Microscopically, sections revealed a sarcoma exhibiting areas of liposarcoma and rhabdomyosarcoma.

A Case of Rrenal Angiomyolipoma: Ho Kun Lee, Tae Sook Lee; J Pathol Transl Med. 1983;17(1):81-85.

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Abstract: Renal angiomyolipoma is a rare benign tumor composed of an intimate mixture of fat, blood vessels, and smooth muscle. But this tumor is often found in patients with tuberous sclerosis. This tumor may also arise independently of this complex and occurs the incidence higher in women when the tumor was not associated with tuberous sclerosis. This tumor tend to arise multifocally and occasionally bilaterally. We have reported a case of angiomyolipoma in 44 years old woman. Grossly, submitted specimen consists of a large kidney, measuring 17×12×8㎝ in dimension and 950gm in weight. On cut section, there are three pseudolobulated yellowish tumor masses with massive hemorrhage. Microscopically, sections from the main masses are composed of numerous fat cells, blood vessels, and smooth muscle.

Gastropathy with Submucosal Glandular Heterotopia: Doo Hwa Yoon, Jung Il Suh, Moon Hyang Park, Hyo Sook Park; J Pathol Transl Med. 1983;17(1):86-93.

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Abstract: 62 year old female and 64 year old male patients underwent subtotal gastrectomy because of adenocarcinoma of the stomach. Two resected subtotal stomachs reveal submucosal glandular heterotopia which are associated with adenocarcinoma. Here we discuss and make effort to clarify the nature and pathogenetic mechanism on the basis of hsitopathologic characteristics of these lesions. They are characterized as follows: 1) Submucosal glandular heterotopia distribute chiefly in the body of anterior and posterior walls. 2) It is composed of cystic and/or hyperplastic mucous epithelium showing clear maturation with no evidence of inflammatory secondary changes such as erosion, degeneration, intestinal metaplasia or borderline atypia. 3) Overlying mucosa reveals diffuse loss of fundic glands and is replaced by pseudopyloric glandular mucous epithelium with often cystic dilatations.

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