Journal of Pathology and Translational Medicine

Volume 8(1); June 1974

Etcs

Clinico-Pathologic Studies on Ovarian Tumors Among Koreans: Jung Sil Cho, Yoo Bock Lee, Dong Sik Kim; J Pathol Transl Med. 1974;8(1):1-14.

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Abstract: The ovary is a complex structure from an embryologic, anatomic, and functional stand-point. Therefore, it is not surprising that tumors originating in this organ are diverse, complicated, and often histogenetically poorly understood. As a corollary, many ovarian tumors are difficult to diagnose. The complexity of ovarian tumors becomes more understandable when it is realized that there is not yet universal agreement as to the origin of such essential structures as germinal epithelium, primordial germ cell, or graafian follicle wall. Tumors are the most common type of lesion encountered in the ovary, and they are a common form of neoplasia in women. Ovarian cancer ranks below only carcinoma of the breast, colon, cervix, endometrium and stomach in the list of common malignancies in the female. With respect to the reproductive tract alone, ovarian cancer accounts for about one-fifth of malignant tumors that occur in this system. The classification of these lesions presents a problem on which there is no unaminity of opinion. The classification differ, depending upon whether the criteria employed are based upon the macroscopic appearance, microscopic architecture, clinical behavior or histogenesis of the tumors. It is not, however, fundamentally different from classifications in recent studies on this subject. Pathologist is expected not only to make a correct microscopic diagnosis using modern terminology but also to supply accurate information about the natural history of a given tumor, thereby guaranteeing the possibility of optimal treatment. This collective review will emphasize current treads in the classification of ovarian tumors, their incidence among Koreans, and comparative incidence in other reports. Materials and Method: Primary and metastatic ovarian tumors were collected that occurred in 454 cases of all age during the period of 12 years from 1961 to 1972. All specimens were fixed in 10% formalin. Gross observations were focused on the size of tumors, cystic or solid in consistency, and capillary growth and locularity of epithelial tumors. For histologic examination, paraffin embedded blocks were cut in 6 M thickness and sections were stained by routine hematoxylin-eosin method. The classification of ovarian tumors was based largely on current concepts and criteria for diagnosis. It includes recognition of the relatively new category of borderline tumors in the serous and mutinous categories. Frequency of psammoma bodies in serous and mucinous tumors were examined for comparison. Age, chief complaints, duration of symptoms and laterality were analysed by means of clinical charts. Also ovarian tumors associated with pregnancy and other lesions were accessioned.
Results
and Summary: Clinical and histopathological studies were made on 454 cases of primary and metastatic ovarian tumors, that were submitted to the Department of Pathology, Yonsei University, College of Medicine, during the period of 12 years, from 1961 to 1972. 1. Among 454 cases, 358(78.991) were benign and 96(21.1%) wire malignant. Metastatic tumors were 19 cases(4.2%). 2. In histologic types, cystic teratomas(175, 38.5%) ranked first followed by mucinous cystadenoma (93cases) and serious cystadenoma and serous cystadengcarcinoma in order of frequency. 3. Benign ovarian tumors showed mean size of 11.0cm in maximum diameter, and malignant tumors was 12.4cm. 4. No site predilection was identified with bilaterality in 22 cases(6.4%) of benign and 14 cases(31.3%) of malignant tumors. 5. Psammoma bodies and papillary growth were more frequently found in serous types than in mucinous types. 6. Mean age of benign ovarian tumors was 35.2 years and malignant one was 41.9 years. 7. Clinical symptoms were abdominal pain, abdominal mass & menstrual disturbance, in order of frequency. 8. There were 31 intrauterine & 4 ectopic pregnancies which were associated with ovarian tumors. Among them, cystic teratomas were 26 cases. In Summary, these findings are comparable to other reports both in Korea and in other countries, except that most frequent histologic type of all ovarian tumors in this review, cystic teratoma(38.5%), ranks 3rd or 4th in other reports, and mean age of malignant of brian tumors, 41.9 years, is much younger than that of other reports(50 years).

Micro Serum Glucose Determinations with Neocuproine Hydrochloride: B.S. Tchai, Kyong Hwan Cho; J Pathol Transl Med. 1974;8(1):15-20.

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Abstract: A simple and micro method for the determination of the blood sugar was studied. serum glucose was estimated by neocuproine hydrochloride method previously described by M.E. Brown. Neocuproine method was compared with a classical Somogyi-Nelson method and also two filtrates namely Somogyi and Folin-Wu were used for the determination of glucose according to the neocuproine method. The values of glucose in serum of thirty seven healthy person by classical Somogyi-Nelson method were 8.60 ±7.5mg/100m1, by Somogyi filtrate-neocuproine method, 85.8±12.4mg/100ml and by Folin-Wu filtrate-neocuproine method, 102 ± 7.4mg/100m1 respectively. The estimation of glucose by a Somogyi-Nelson procedure and by the neocuproine is affected by the protein-free filtrate, and intraprocedual differences are small. However, consistantly lower values are obtained by the Somogyi-Nelson and Somogyi-neocuproine methods and probably represent a mere valid index of true serum glucose than the Folin-Wu neocuproine procedure.

Histiocytic Medullary Reticulosis -Report of Five Cases-: Sang In Kim, Hyun Sook Chi, Bo Ryun Kim, Young Hee Choi, Yong Il Kim; J Pathol Transl Med. 1974;8(1):21-27.

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Abstract: Five cases of histiocytic medullary reticulosis diagnosed by authors at the Seoul National University Hospital during 1971 to 1973 are presented with clinical summary, laboratory results and hematological findings of peripheral blood and bone marrow. The results are summerized as follows: 1. Four out of five cases were male with average age of 20, and male to female ratio was 4 : 1. 2. Four patients died during hospitalization and their mean survival from the onset of disease to the death was 121 days. 3. All case disclosed clinical manifestation of high fever, hepatosplenomegaly and/or lymphadenopathy and bleeding tendency or icterus. 4. Peripheral blood showed severe anemia, thrombocytopenia (4 cases showed less than 40,000/mm3 of platelets at the end-stage), leukopenia (mean WBC total count was 1,700/mm3 at the end-stage) and prolonged bleeding & prothrombin time. 5. All cases had atypical monocytes in peripheral blood smears with erythrophagocytosis(3 case)or phagocytosis of platelets or other cell debris. 6. Bone marrow showed hypoplasia and increased number of atypical monocytes with slightly increased proportion of lymphocytes, plasma cells and normoblasts, Careful examination of bone marrow disclosed an erythrophagocytosis in monocytic cells even in those cases with little monocytic hyperplasia. 7. Though the histocytic medullary reticulosis is a rare disease, an attention and careful study will find more cases in Korea.

Acute Hepatic Alterations Induced by Aflatoxin B₁ -Correlation of Histopathologic Findings with ³H-thymidine Uptake by Autoradiography and Mitotic Index-: Moon Ho Yang, Chae Koo Lee; J Pathol Transl Med. 1974;8(1):29-40.

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Abstract: Acute hepatic alterations was induced in young male rats by a single intraperitoneal injection of aflatoxin B₁ dissolved within diaethylsulfoxide, and their histopathologic characteristics were correlated with mitotic activity and incooperation of 3H-thymidine uptake into hepatocytes and Kupffer cells using microautoradiography. 1. Major morphological changes in the earl phase included little periportal necrosis but accompanied features of much significant hepatocellular degeneration and unrest as well as kupffer cell reaction and minimal ductular cell proliferation; Evidences of hepatocellular injuries started to appear within 24 hours after exposure, but became regressed 72 hours later to restore normal hepatic architectures and cellular details after the 7th day. 2. Indices of both 3H-thymidine uptake and mitosis of the hepatocytes was lowest at the 24 hour-group, being followed by rather rapid increase up to the levels of 2∼3 times higher than those in the control group at the 5th day, and thereafter both returned to the normal status. 3. Those transient increases of both indices were assumed to be resulted by compersatory proliferation for hepatic injuries. 4. Hepatic megalocytosis during morphological architectural restore supported that abnormal increase of metabolism was involved against antimetabolic effect of aflatoxin. 5. Kupffer cells were also similarly but less severely affected by aflatoxin in terms of both 3H-thymidine uptake and mitotic indices. The above features during the early phase of hepatic alterations suggested that administration of aflatoxin B₁ results in impairment or blockage of DNA synthesis and antimetabolic effect within 24 hours on both hetpatocytes and kupffer cells, after which both of 3H-thymidine uptake and mitotic indices return to the normal as with morphologic restorement.

Intrahepatic Colloid Deposit in Kupffer Cell: Yong Il Kim, Jin Soo Lee, Jae Hoon Koo; J Pathol Transl Med. 1974;8(1):43-47.

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Abstract: A histologic and histochemical study on ten cases of the liver needle biopsy specimens disclosing smudgy, pale basophilic, globular, aggregations mainly localized within the hepatic Kupffer cells, was made to clarify the nature of substance and tissue reaction. 1. The material lay mainly with in Kupffer cells freely in the hepatic sinusoids or in the portal spaces. 2. Hematoxylin-eosin stained sections revealed aggregations of pale to deep blue globular substance measuring 10-100 μ in diameter, and accompanied a mild lymphocytic and histiocytic reaction except in one which was characterized by foreign body type granulomas. 3. Histochemical reaction of the material to PAS, mucicarmine and alcian blue stains gave all negative reactions. 4. Two cases presented histories of receiving either periston and/or dextran as plasma expander. 5, These all of cases revealed no hepatic dysfunction in regard to the deposit. 6. Nature and pathogenesis of the colloidal material were not identified but it is suggested that deposit of certain exogenous nonmucinous substances as with polyvinyl pyrrolidone would participate on to the intrahepatic colloidal deposit.

Histopathologic and Clinical Studied of the Salivary Gland Tumors among Koreans: Kwang Kil Lee, Jin Kook Choe, Chi Whan Kim, Chung Sook Kim, In Joon Choi, Yoo Bock Lee, Dong Sik Kim; J Pathol Transl Med. 1974;8(1):49-59.

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Abstract: Ninety five cases of salivary gland tumors were reviewed in histopathlogic and clinical aspects. The results were as follows: The average age of patients was 37.9 years. Overall cases showed female predominance with 1.7 : 1 of male to female ratio, but malignant mixed tumors were more frequent 1.3 times in males. The chief complaints were palpable mass (87.3%), pain(14.5%: facial nerve paralysis (9.1%) and swelling(7.3%) in order of frequency and the duration of the disease was over one year in most of the patients(88.5%). As the location, 49.4% occurred in the major salivary glands and 40.0% in the minor. The parotid gland was the most frequent site with 35.8% of the total, and the next were palate (18.9%), submaxillary gland(11.6%) and nasal cavity and maxillary sinus(10.6%). The tumors were benign in 57.9% and malignant in 42.1%. The most frequent histological type was benign mixed tumors (57.9%) and the next were adenoid cystic carcinoma (21.6%) and mucoepidermoid carcinomas(9.5%). Most of mixed tumors in the minor salivary glands occurred in the palate and all of thens were benign in character. Adenoid cystic carcinoma was most frequent in the basal cavity and maxillary sinus and the next was in the tongue. It seems that both the epithlial and myoepithelial cells take part in the formation of the mixed tumor favoring the opinion of Yates and Paget(1952), Azzopardi and Smith(1959) and Hubner et al. (1971).

Bilateral Ovarian Luteomas of Pregnancy -Report of a Case-: Sang In Shim, Chong Moo Lee; J Pathol Transl Med. 1974;8(1):61-64.

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Abstract: A case of luteoma of pregnancy occurring in a 31 years old multiparous woman, and found incidentally during a cesarean section for placenta previa and transverse position of the fetus, was reported. The gross and microscopic findings of the present case strongly supported that this lesion is a benign, generally non-functioning, lutenized stromal cell hyperplasia, probably due to an overactive physiologic response of the ovary to chorionic gonadotropins. A brief review of the literature was made.

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