Journal of Pathology and Translational Medicine

Volume 13(2); December 2002

Original Articles

The Usefulness of Fine Needle Aspiration Cytology of Bone Lesions.: Bohng Hee Kim, Gyung Yub Gong; Korean J Cytopathol. 2002;13(2):51-59.

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Abstract PDF: To determine the usefulness of fine needle aspiration cytology(FNAC) of bone lesions and the complementary role of FNAC and percutaneous needle biopsy, 75 cases of FNAC taken from bone lesions were analyzed. Correlations with histopathology were possible in 47 cases, including 14 cases of simultaneous core biopsy and 33 cases of subsequent open biopsy due to inadequate aspirates. Among 75 cases, 4 cases were benign tumors and tumor-like lesion, 11 cases were malignant primary bone tumors, 17 cases were metastatic tumors, and 43 cases were nonneoplastic bone lesions. The aspirates were adequate in 35 cases(46.7%), in all of which the discrimination between benignancy and malignancy was possible. The main reason for inadequate aspirates was due to hypocellularity. In the cases of aspiration and core biopsy simultaneously done, the diagnostic accuracy of aspiration, core biopsy, and both were 57%(8/14), 78.6%(11/14), and 92.9%(13/14), respectively. We conclude that a final diagnosis based on cytology is possible with the adequate aspirates and the clinical and radiological findings. Also we confirm the complementary role between FNAC and core biopsy in bone lesions.

Fine Needle Aspiration Cytologic Features of Follicular Lymphoma.: Jin Haeng Chung, Hwa Jeong Ha, Sun Hoo Park, Jae Soo Koh, Min Suk Kim, Seung Sook Lee, Kyung Ja Cho; Korean J Cytopathol. 2002;13(2):60-65.

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Abstract PDF: The accuracy of fine needle aspiration cytology(FNAC) for the diagnosis of follicular lymphoma was investigated by a review of 13 FNAC specimens from 10 patients. All patients included in this study were confirmed by surgical biopsy preceded by FNAC. Three aspirates were unsatisfactory because of scanty cellularity. Among the remaining 10 cases, 5(50%) were diagnosed as lymphoma, 3(30%) as reactive hyperplasia, one(10%) as metastatic small cell carcinoma, and one(10%) as granulomatous inflammation. Cytologic distinction between follicular lymphoma and reactive hyperplasia is very difficult with cytomorphology alone. Compared to reactive hyperplasia, the characteristic cytologic features such as relatively homogeneous cellular constituent, paucity of tingible body macrophages and lymphohistiocytic aggregates, and less mitotic activity in follicular lymphoma are important findings to prevent false negative diagnosis. In addition, lymphoglandular bodies are useful in distinguishing malignant epithelial tumor from lymphoid lesion.

Usefulness of Cytologic Study of Intraoperative Suction Fluid in Brain Tumors.: Hye Kyung Lee, Hyun Gjin Lee, Eun Hee Lee, Hee Jung Kim, Il Woo Lee; Korean J Cytopathol. 2002;13(2):66-69.

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Abstract PDF: In diagnosing a brain tumor, it is essential to obtain samples from many areas of the tumor. Although there are reports about the suitability of material obtained by cavitron ultrasonic surgical aspirator(CUSA), there is a paucity of reports regarding conventional intraoperative suction. This study was performed to evaluate the usefulness of the suction fluid and the effect of different hemolytic fixatives. Intraoperative suction fluid was obtained from 2 pituitary adenomas and 2 choroid plexus carcinomas. In two cases of mixed astro-oligodendroglioma, one of glioblastoma multiforme and 3 of meningioma, the fluid was collected by CUSA. Each sample was divided into four bottles for the different fixatives such as 0.1N HCl, 10% acetic acid, 95% alcohol, and no additive. All cases were evaluated by the both cytologic smear and cell block preparations, and were reviewed with concomitant histologic diagnosis. The result showed a good correlation between the cytologic study and the histologic diagnosis and 95% alcohol was found to be superior to other fixatives in cell preservation.

Case Report

Fine Needle Aspiration Cytology of Ameloblastoma: A Case Report.: Hee Jeong Lee, Eun Sun Jung, Byung Kee Kim, Chang Suk Kang; Korean J Cytopathol. 2002;13(2):70-73.

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Abstract PDF: Utilization of fine needle aspiration cytology(FNAC) in the diagnosis of odontogenic tumors seems to have little attention. Ameloblastoma is the most common epithelial odontogenic tumor. However, the cytologic findings of ameloblastoma are described recently. We report a case of ameloblastoma diagnosed by FNAC. The aspirated blood-tinged mucoid fluid from maxillary mass showed a few clusters of tumor cells with distinct two-cell population: basaloid cells with palisading arrangement and squamous cells with more abundant and eosinophilic cytoplasm. Nuclear atypism, pleomorphism or mitosis were absent. A few keratinized bodies in the tumor cell clusters and the third component, stellate cells were also characteristic.

Etc

Histopathological Study on Germ Cell Tumors of Hypothalamic Region -A Report of 5 Cases-: Eun Joo Seo, Chong Moo Lee*, Jin Un Song**; Korean J Cytopathol. 1979;13(2):73-76.

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Abstract: Intracranial tumours histologically identical with seminoma or dysgerminoma of the gonads have been called ectopic pinealoma, germinoma and atypical teratoma. The origin of these tumors is difficult to explain. Primitive germ cells migrate over wide areas of the embryo during early embryonic life. Very occasionally such germ cells have been observed within the developing brain of the embryo. We have experienced 5 cases of intracranial tumors which were confirmed histopathologically as germinoma or teratoma during last 5 years at St. Mary Hospital, Catholic Medical College. The patients were between 12 and 23 years old. All of the cases were males except one case of germinoma. The chief complaints of the male patients were nausea, vomiting and visual disturbances, and histological diagnosis of these cases were 3 germinoma and 1 teratoma. The female patient was 21 years old. The symptoms were those of diabetes inspidus such as polydipaia and polyuria, nausea, vomiting, weight loss and amenorrhea of several months duration. Histologically, it was proved as germinoina.

Case Reports

Fine Needle Aspiration Cytology of Lymphoepithelial Carcinoma of Parotid Gland: A Case Report.: Sung Jig Lim, Jung Yeon Kim, Kyeong Mee Park; Korean J Cytopathol. 2002;13(2):74-77.

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Abstract PDF: Lymphoepithelial carcinoma, also known as malignant lymphoepithelial lesion or lymphoepithelioma, is a rare tumor in salivary glands. Lymphoepithelial carcinoma has a characteristic histological findings comprising irregularly-shaped nests of malignant epithelial cells within a lymphocyte-rich stroma, occasionally forming lymphoid follicles. We recently experienced a case of fine needle aspiration cytology(FNAC) of lymphoepithelial carcinoma of parotid gland in a 61-year-old male. The FNAC yielded a hypercellular smear of many irregular clusters of malignant epithelial cells in the background of lymphoid stroma.

Urinary Cytologic Findings of Small Cell Neuroendocrine Carcinoma: A Case Report.: Dong Hoon Kim, Dong Wook Kang, Kyung Hee Kim, Ju Heon Kim, Mee Ja Park; Korean J Cytopathol. 2002;13(2):78-83.

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Abstract PDF: We report the cytologic features of a case of primary small cell carcinoma of the urinary bladder with high grade transitional cell and signet ring cell carcinomatous components. A 64-year-old male presented with gross hematuria for one week. Computed tomography revealed an ill-defined mass in the left lateral wall of the urinary bladder. Urinary cytology showed hypercellularity with predominantly isolated single cells and clustered cells. They have scanty cytoplasm and naked hyperchromatic nuclei with finely granular nuclear chromatin and rare nucleoli. The tumor cells occurred predominantly singe cells, but a few in clusters. Nuclear molding was prominent. No glandular formation or nesting was noted. The second tumor cells had high nuclear/cytoplasmic ratio, irregular nuclear membrane, and coarse granular chromatin. The background was inflamed and necrotic. The histologic findings of transurethral resection were mainly composed of small cell carcinoma, and partly transitional cell and signet ring cell carcinomatous components. Small cell neuroendocrine carcinoma have distinctive cytologic features to make a proper diagnosis.

Etcs

Histopathological Studies in the Liver Cell and Adrenal Glands in Case of Stress: Chae Hong Suh; Korean J Cytopathol. 1979;13(2):79-82.

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Abstract: The author has examined the influence of emotional cold stressor upon the liver cells and adrenal glands of rats histopathologically. Consequently the author has drawn the following conclusions : 1. In view of the fact that the characteristic histopathological changes brought about by the non-specific harmful agents mentioned above are common to the liver cells, and that the changes are closely connected with the function of adrenal cortex, these changes should be looked upon as a manifestation of the reaction of organism upon the stress, manely, as a part of General Adaptation Syndrome (Selye). 2. The Stress has a stimulating effect not only on the zona fasciculata, but also on the zona glomerulosa. However, the manifestation of the stimulating effect upon both zones shows discrepancy of time.

A Study on Hemoglobin Electrophoresis in Healthy Adult Persons, Newborns at Birth and Patients with Anemic Diseases: Eun Yup Lee, Soon Ho Kim; Korean J Cytopathol. 1979;13(2):83-92.

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Abstract: The author investigated hemoglobin types in the peripheral blood obtained from antecubital vein of 90 cases of the healthy adult persons and 18 cases of the patients with anemia, and in the cord blood of 30 cases of the newborns at birth. The patients with anemia consisted of 6 cases of iron deficiency anemia, 6 cases of aplastic anemia and 6 cases of malignant tumor associated with anemia. The hemoglobin concentration estimated by cyanmethemoglobin method and the hemoglobin types estimated by cellulose acetate electrophoresis. The results obtained were summarized as follows : 1. In the healthy adult persons, the mean hemoglobin concentration was 16.0±1.2g/dl in male and 14.4±1.3g/dl in female. The mean percentages of HbA and HbA2 were 96.83±0.58 and 3.12±0.58%, respectively. 2. In the newborns at birth, the mean hemoglobin concentration was 16.7±1.5g/dl and the mean percentages of HbA and HbF were 27.3±5.5% and 72.7±5.5%, respectively. 3. In the patients with aplastic anemia, the mean percentages of HbA, HbA2 and HbF were 93.7±1.7, 2.6±0.4% and 4.2±1.8%, respectively. The mean percentage of HbF in the patients with aplastic anemia was significantly increased than that in the healthy adult persons, while the mean percentages of HbA and HbA2 were significantly decreased. 4. In the patients with iron deficiency anemia, the mean percentages of HbA and HbA2 were 97.6±0.4 and 2.4±0.4%, respectively. The mean percentage of HbA in the patient with iron deficiency anemia was significantly increased than that in the healthy adult persons, while the mean percentage of HbA2 was significantly decreased. 5. In the anemia patients with malignancy, the mean percentages of HbA and HbA2 were 96.8±0.78% and 3.2±0.78%, respectively. And the mean percentages of HbA and HbA2 were not significantly different between the healthy adult persons and the anemia patients with malignancy. According to these results, it may be somewhat helpful to estimate the hemoglobin types in the diagnosis and treatment of aplastic anemia and iron deficiency anemia.

Case Reports

Fine Needle Aspiration Cytology of Tubulolobular Carcinoma of the Breast: A Case Report.: Ji Shin Lee, Young Bog Kim; Korean J Cytopathol. 2002;13(2):84-87.

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Abstract PDF: Tubulolobular carcinoma is a tumor of the breast that shares histologic features of both tubular and lobular carcinoma of the breast. The cytologic features of this neoplasm have not been reported in Korea. We described a case of tubulolobular carcinoma diagnosed by fine needle aspiration cytology in a 46-year-old female. The tumor contained several cytologic features of both tubular and lobuar carcinoma, including tubular structures, single filing of cells, intracytoplasmic vacuoles, and low nuclear grade.

Two Cases of Invasive Carcinoma of the Breast Composed Mostly of Signet Ring Cells in the Fine Needle Aspiration Cytology.: Won Mi Lee, Wan Sup Kim, Eun Kyung Kim, Jong Eun Joo; Korean J Cytopathol. 2002;13(2):88-92.

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Abstract PDF: Scattered single cells or variable sized clusters of signet ring cells in the aspirated smears of breast lesions are almost exclusively associated with carcinoma. The signet ring cells are defined as those containing a prominent intracytoplasmic vacuole or amorphous cytoplasm diffusely dispersed with mucin. The primary signet ring cell carcinoma of the breast behaves more aggressively than carcinoma without signet ring cells. Therefore, it is very important to make a correct diagnosis of signet ring cell carcinoma. Fine needle aspiration cytology is useful for diagnosis of breast lesions including signet ring cell carcinoma. We report two cases, which showed mostly signet ring cells in the aspirated smears of the breast. One case consisted of numerous individual signet ring cells and variable sized cell clusters in rather mucoid background. The tumor cells had abundant amorphous cytoplasm filled with dispersed mucin or occasionally mucin vacuoles(PAS +) and eccentric nuclei. The resected mass revealed mucinous carcinoma. The other showed the cytologic findings of low cellularity, and small loosely cohesive signet ring cell clusters with mild nuclear pleomorphism. It was confirmed as lobular signet ring cell carcinoma in the resected tumor.

Etcs

The Serum CAP and LAP Activities in Normal Pregnant Women: Su Ja Chu, Sun Ock Oh, Myong Joon Cho; Korean J Cytopathol. 1979;13(2):95-101.

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Abstract: The values of the serum cystine aminopeptidase and leucine aminopeptidase activities in clinically healthy pregnant women have been studied using Iatron Kit according to months of gestation periods. 1. The serum cystine aminopeptidase and leucine aminopeptidase activities in extensively normal women (control group) were 13.75±2.67 munit/ml. and 170.33±33.39 G-R unit/ml. respectively, and fail to show remarkable changes in early pregnancy (up to 5 months of periods). 2. The mean CAP and LAP activities in normal pregnant women showed progressively increasing tendency by months of gestation with a mean of 175±64.30 munit/ml. and 517.2±165.47 G-R unit/ml. at term. About 15 fold increased value in CAP and 3 to 4 fold increased value in LAP than those of early pregnancy and control group were noted at term. 3. A positive correlation (P<0,005) was found between cystine aminopeptidase and leucine aminopeptidase activities in pregnant women. It is, therefore, suggested that the comparative evaluation of cystine aminopeptidase and leucine aminopeptidase activities, relatively simple and easy to perform, could be used as a parameter in judging the functional state of the placenta during late pregnancy.

A Histopathological Study of Brenner Tumor of Ovary -A report of 3 cases-: Hea Soo Koo, Moon Hyang Park, Hyo Sook Park; Korean J Cytopathol. 1979;13(2):103-109.

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Abstract: Brenner tumor is a rare neoplasm of the ovary and there is general agreement that he tumor is derived from surface (coelomic) epithelium. We have experienced three cases of Brenner tumor in Pathology department of National Medical Center during 4 years and 6 months from Jan. 1975 to June 1979, which comprised 2.1% of 142 all benign ovarian tumors. The size of tumor was variable from microscopic to 15cm. in maximal diameter. Two of them were bilateral and another one had marked calcification in the stroma. One of the three cases was accompanied by mucinous cystadenoma. None of them showed proliferating or malignant pattern.

A Case of Sebaceous Epithelioma: Song Hoi Park, Je Geun Chi, Yong Il Kim; Korean J Cytopathol. 1979;13(2):111-115.

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Abstract: The sebaceous epithelioma is a rare variety of skin tumor, the histogenesis of which is not clearly elucidated. Their clinical character, localization and age incidence are very similar to basal cell epithelioma, but they have small number of mature sebaceous cells as tumor element, The main pathologic finding is proliferation of basaloid germinative cells of the sebaceous glands. We experienced a case of a recurrent sebaceous epithelioma of the right parotid area in a 37-year-old woman. She had her tumor removed at the same site one year previously. The clinical impression was neoplasm of salivary glands. The tumor was located just beneath the focally ulcerated skin, and was partly encapsulated and lobulated and measured 4×2.5×2.5cm. Cut surface was homogeneously yellowish white, showing lobule formation by fibrous septa of varying thickness. Areas of hemorrhage and cystic change were seen. Microscopically there were poorly defined masses of cells of basaloid shape. There were many cystic spaces, containing amorphous hyaline-like material. This material appeared foamy and in glaces vacuolated. The tumor masses consisted of two cell types, one was similar to that seen in the basal cell epithelioma and the other was sebaceous in nature. Germinative cells were predominant throughout and invaded the fibrous septa. Mild inflammatory infiltrates were present in areas. The overlying epidermis was relatively well maintained except for focal ulceration.

A Case of Anorectal Malignant Melanoma: Kyung Ho Shin, Jae Sik Kim, Jyung Myung Kim, Eun Sook Chang*; Korean J Cytopathol. 1979;13(2):117-121.

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Abstract: The malignant melanoma of the anorectum is relatively rare and is highly virulent. There are only two cases reported in Korea, as far as our knowledge is concerned. In March 1979, we experienced a case of anorectal malignant melanoma, in a 50 years old woman. A case presentation with histopathological findings and a brief review of the literature were done.

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