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Volume 18(4); December 1984
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Paraquat Intoxication on Rat Lung -Fractional Bronchoalveolar Lavage Analyses compared with Histological and Ultrastructural Studies-
Sang-Sook Lee, Oichi Kawanami*, Kaoru Aihara**, Chai-Hong Chung, Yasuhisa Hirohat**
Korean J Cytopathol. 1984;18(4):333-344.
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AbstractAbstract
Wister 백서폐의 실험적 paraquat 중독이 잠정적으로 분할적 기관지폐포세정법(Fractional Bronchoalveolar Lavage, FBAL)이라고 불리는 새로운 방법에 의하여 연구되었다. 광학 및 전자현미경적 관찰도 동시에 행하여졌다. 기관지폐포 세정액(BAL) 세포성분의 분할적 분석의 urf과, 정상백서에서는 임파구와 다핵백혈구의 비가 첫 분설에서 가장 높고 둘째, 셋째 분설로 갈수록 점차 감소되는 것이다. 이러한 분포는 염증세포의 대체적인 분포를 나타내어 즉, 첫 분설에서 얻어진 세포들은 기관지의 기도에서 나온 것이고 나머지 분설들은 주로 최말단폐조직에서 유래된 것을 말해준다. 저자들의 연구에서 본 바 paraquat 중독의 급성기에서는 BAL의모든 분설에서 호중구와 임파구의 높은 비를 보여 이는 전폐조직을 통해 호중구가 존재하는 조직소견과 일치되었다. 만성기에서는 임파구의 비가 BAL의 모든 분설에서 심하게 증가되었는데 이는 비대한 BALT(bronchus-associated lymphoid tissue)와 말초폐조직의 임파구 침윤과 관계되었다. 이러한 자료는 BAL액 세포성분의 분할적 분석이 세포층에서 폐질환의 병원론을 유추하는데 중요한 역할을 하는 호흡계의 각각의 immune-effector cells의 분포를 추정하는데 도움을 준다고 믿어지는 바이다.
An Ultrastructural Study on the Changes in Hepatocyte of Rat Induced by Vitamin A Deficiency
Hang Ik Bae, Yun Kyung Sohn, Kyung Rak Sohn, In Soo Suh, Tae Joong Sohn
Korean J Cytopathol. 1984;18(4):345-355.
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AbstractAbstract
In order to investigate the morphologic changes of hepatocyte by vitamin A deficiency, the author fed vitamin A deficient diet by Lamb's formula to male weanling Sprague-Dawley rats. Twenty rats were divided into two groups(14 as experimental group and the rest 6 as control). Two rats of control groups and 2, 4 and 8 rats of experimental groups were sacrificed 20th, 40th and 60th days and each hepatic tissue was observed by the light and electron microscopes. The results were summarized as follows: Light microscopically, hepatocytes of experimental group showed mild inflammatory reactions accompanied by Kupffer cell hyperplasia and disarray of hepatic cords. Electron microscopically, mitochondria showed marked variablity in size and shape with increased distorted cristae as well as increase of matrix densities. Degenerative changes of the cellular organelles participating in protein synthesis and transports were noted, such as dilatation and fragmentation of RER, shedding of ribosomes, increase of free ribosomes, atrophy of Golgi complex, and decrease of SER. Lysosome was not increased but multivesicular lysosomes were occasionally found. From the above results, vitamin A deficiency may specifically alter the morphology of mitochondria and induce multivesicular body formation. Mallory body formation is not noted. Changes on the other endomembranous structures are believed to be secondary.
Ultrastructural Study on the Mechanism of Nephrotoxicity Induced by Endotoxin
Byung Heon Kim, Sun Kyung Lee*
Korean J Cytopathol. 1984;18(4):356-374.
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AbstractAbstract
The author studied the morphologic changes on the glomeruli and tubular structures to clarify the mechanism of nephrotoxicty induced by endotoxin. Also studied was the changes in the permeability of microvasculature at the electron microscopic level using peroxidase as enzymatic electron tracer by the vascular clearance method. Male Sprague-Dawley rats were received 3 mg per kg of body weight of E. coli endotoxin and then sacrified 30, 60, 120, 180, and 300 minutes after injections of the endotoxin, respectively. Another groups of animals were received additionally intravenous injection of peroxidase 5 minutes before their sacrifices in each group. The results obtained were summarized as follows: Light microscopically, the glomeruli showed mild congestion and infiltration of leukocytes, which remained in the same degree throughout. The tubular epithelial cells showed intracellular edema from the early stages and regenerative changes appeared in later times. Electron microscopically, endothelilal cells of the glomeruli and peritubular capillaries showed vacuolization and protrusion of cytoplasmic process toward luminal spaces. The tubular epithelial cells showed intracellular edema from the early stages and regenerative changes appeared in later times. Electron microscopically, endothelial cells of the glomeruli and peritubular capillaries showed vacuolization and protrusion of cytoplasmic process toward luminal spaces. The tubular epithelial cells showed swelling of mitochondria, detachmetnt of ribosomes, swelling of RER and attenuation of basal infolding structures, which were more prominent in later times. Lysosomes appeared from the time 3 hours after injections of endotoxin, and increased in later stages. Some epithelial cells were detached out from the basement membrane in later time, but the basement membrane itself seemed to be intact until the time 5 hours after injection of endotoxin. Peroxidase treated groups showed reactive products to peroxidase in the luminal spaces in both of control and experimental groups until 3 hours, but they were remained within basal layer of the cell in the experimental group after 5 hours, which indicated inhibition of permeability of the particulated material in endotoxin treated group in later time. The results of this study suggested that tubular structures were more severly affected by endotoxin in earlier stage, which indicated that injury to the tubule did participate in the role initiating renal injury which therefore in thought to be the basis for acute renal insufficiency than glomerular injury in endotoxemia.
Cancer of the Gallbladder: A Review of 73 Cases with Emphasis on Relationship to Gallstones
Sang Sook Lee, Eun Sook Chang, Chai Hong Chung
Korean J Cytopathol. 1984;18(4):375-381.
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AbstractAbstract
This study presents the clinicopathologic findings in 73 cases of cancer of the gallbladder. Particular attention was paid to the presence of gallstones, classification of histologic types, along with their distribution by age and sex, the presenting symptoms and the sites of metastasis. The bulk of the cases occurred in elderly females and the most common histologic type was adenocarcinoma. The incidence of gallbladder cancer in the cholecystectomy population runs about 4.2%; in the cholelithiasis population only 2.1%. Of total 70 cases of gallbladder cancer, 18.6% had gallstones. There does not appear to be a correlation between gallbladder cancer and cholelithiasis when calculated from the gallstone incidence. Cholecytectomy solely hoping to prevent cancer in cholelithiasis patients is not advisable.
Histopathological Study of the Gastrointestinal Polyps
So Young Jin, Yoo Bock Lee
Korean J Cytopathol. 1984;18(4):382-397.
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AbstractAbstract
The present study is aimed to evaluate the relationship be tween the histologic type and malignant potential of gastrointestinal polyps. The material consists of polyps obtained from 256 patients and examined at the Department of Pathology, Yonsei University College of Medicine from January, 1968 through December, 1982. After the classification of polyps by the histologic type, age and sex of the patients, size and shape of polyps, site, clinical symptoms, and dysplastic change were reviewed. Special stains such as periodic acid-Schiff, alcian blue pH 2.5 and 1.0, and Spicer's high iron b diamine method were applied for the demonstration of the amount and the character of mucin. Results obtained were as follows: 1) The cases consist of 46 gastric polyps and 211 colonic polyps. Terminal ileum was involved by a case of familial multiple polyposis. The multiplicity rate was 4.84. The hyperplastic polyp was the predominant histologic type among gastric polyps and the retention polyps. Seven cases of familial multiple polyposis and two cases of Peutz-Jeghers syndrome were observed. 2) The overall male to female ratio was 1.39 : 1. The hyperplastic polyp was distributed evenly from the 3rd decade of life. The tubular adenoma was predominant in the 5th and 6th decades, the villous adenoma in older age than the tubular adenoma, the retention polyp in the 1st decade, and the familial multiple polyposis in the 4th decade. 3) The size of polyps was than 1.5㎝ in diameter in most of the hyperplastic polyps. Otherwise the tubular and the villous adnomas had significant number of larger size. The retention polyps were variable in their size. 4) By Yamada's criteria of gross type the hyperplastic polyp and the tubular adenoma belonged to the type III, the villous adenoma type I, and the retention polyp type IV. 5) The large majority of gastric polyps arose in the antrum with the highest incidence in hyperplastic polyps. The large majority of colonic polyps arose in the rectum and sigmoid with the highest incidence in villous adenomas at rectum. 6) The patients with gastric polyps complained of epigastric pain or discomfort and the patients with colonic polyps, rectal bleeding. The average duration was within 6 months. 7) Fifteen cases of polyps were associated with carcinoma, which consisted of 14 adenocarcinomas and 1 epidermoid carcinoma. 8) About 30% of gastric and colonic polyps showed dysplastic change. The histologic types such as the tubular adenoma, villous adenoma, and familial multiple polyposis only showed dysplasia, which is milder in tubular adeonma and more severe in villous adenoma. Highest incidence of malignant change was associated with polyps of Yamada type I. 9) Special stains showed normal mucosal mucous pattern in the hyperplastic and retention polyps. The number of goblet cells and the amount of mucus were slightly decreased in the tubular and villous adenomas and markedly decreased in polyps with dysplasia, i.e.; gastric polyps showed decrease in neutral mucin and colonic polyps decrease in sulfomucin. And these were directly related to the degree of dysplasia.
ThymomaThree Cases of Papillary Cystic Neoplasm of Pancreas and Histogenetic Consideration
So Young Jin, Woo Ik Yang, Kwang Kil Lee
Korean J Cytopathol. 1984;18(4):398-408.
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AbstractAbstract
Thymus has been regarded as an important organ in its endocrinologic and immunologic role. The natural history and associated syndrome of its neoplasm is not still uncovered completely. We studied the clinicopathologic features of 14 cases of thymoma. 1) The thymomas occurred largely in the fifth decade with slight male preponderance. Nine patients complained of compression symptoms, three myathenic symptoms, and two no subiective symptoms. Four thymomas were associated with myasthenia gravis. 2) The thymomas were located in the anterior mediastinum and 5 to 17 cm its largest diameter. Grossly 7 thymomas were encapsulated. Gross tumor invasion or implants was noted in 8 cases, most frequently into the pleura. Encapsulation was inversely correlated with gross invasion or implants. 3) Five of the thymomas were predominant epithelial type, 3 predominant lymphocytic type, 4mixed type, and 2 spindle cell type. 4) Among 8 cases which showed gross invasion or implants only 4 cases showed malignant histologic pictures. In conclusion the diagnosis of thymoma should be made on the basis of not only histologic features but also clinical findings including operation findings.
Three Cases of Papillary Cystic Neoplasm of Pancreas and Histogenetic Consideration
Han Ik Bae, In Soo Suh, Tae Joong Sohn, Sae Kwang Moon*
Korean J Cytopathol. 1984;18(4):409-416.
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AbstractAbstract
Three cases of papillary cystic neoplasm of pancreas were experienced in young females(20,26 and 23 years old respectively). Chief complaints were only mass and intermittent pain on epigastrium. All laboratory data were insignificant except huge masses on the epigastrium. Well circumscribed masses were noted in body(1 case) and tail (2 cases), measuring 20, 12 and 16 cm in diameters respectively, which were simply excised, radically resected and distal pancreatectomized. Cut surfaces showed thick fibrous capsules containing solid mass with partially cystic areas filled by hemorrhage and necrosis. Evidence of metastasis was not noted in all cases. Microscopically, they showed typical patterns of papillary cystic tumor described by others. Ultrastructurally, tumor cells showed two different tones of cytoplasm; dark and light. They showed indented nuclei, abundant mitochondriae, but zymogen granules and neurosecretory granules were not noted. These findings suggested that the tumor was originated from small ducts associated with intercalated duct. All patients are in good conditions for 14, 16 and 12 months after surgery respectively.
A Case of Mucoepidermoid Carcinoma of the Bronchus
In Sook Chung, Sook Jin Gang, Sung Sim Kim, Sang In Shim, Sun Moo Kim
Korean J Cytopathol. 1984;18(4):417-421.
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AbstractAbstract
The mucoepidermoid carcinoma is a rare tumor arising in the bronchial submucosal glands that shows an intimate admixture of glandular elements and sheets of cells with little or no definite squamous differentiation. The low grade mucoepidermoid carcinoma is a characteristic and readily recognized tumor. The very rare high grade mucoepidermoid carcinoma must be distinguished with care from the much more common adenosquamous bronchogenic carcinoma. The present case was a 45-year-old female patient with a several-year history of right chest pain and a few-day-history of coughing, fever, dyspnea. Under the bronchoscopic impression of the bronchial adenoma, right middle and lower lobectomy was done. Grossly, the endobronchial mass, 1.2×1.2cm, was located at the mainsterm bronchus branching to middle and lower lobe. It was well circumscribed. It occluded most of the bronchus supplying the lower lobe. The cut surface was whitish gray, relatively smooth and firm. Microscopically, the tumor consisted primarily of large cells, growing in sheets. Keratinization is absent in these epidermoid area. Interspersed among these cells, are mucus- producing individual cells. Mucous containing glands of various size and shape are numerous and widely scattered in the tumor. Cellular atypism and mitoses were absent.
A Case of Malignant Mixed Tumor Arising from the Extrahepatic Bile Duct
Woo Ick Yang, Sang Hoon Mun*, In Joon Choi
Korean J Cytopathol. 1984;18(4):422-424.
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AbstractAbstract
A case of malignant mixed tumor of the main hepatic duct in a 49-year-old woman is reported and a review of the literature is made. The tumor was a polypoid mass, which occluded the common hepatic duct. Histologically the tumor was composed of various components representing, each adenocarcinoma, fibrosarcoma and osteogenic sarcoma. Interesting finding was diffusely scattered argyrophilic cells at adenocarcinoma area by Grimelius staining. This appears to be the first case of malignant mixed tumor of the extrahepatic bile duct.
Ultrastructural Observation on Melanosis Coli
Hye Kyung Lee, Yong Il Kim, Geung Hwan Ahn, Jae Gap Park*
Korean J Cytopathol. 1984;18(4):425-431.
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AbstractAbstract
Histochemical and ultrastructural observations were carried out on pigments in melanosis coli from a 71 years old male who has taken laxatives(laxenta® and dulcolax®) for 3 years and received a left hemicolectomy on adenocarcinoma of the descending colon. The pigments were confined within the lamina propria of entire non-neoplastic colonic mucosa and showed histochemical reactions similar predominantly to lipofuscin but with partial overlapping with those in melanin pigments. Ultrastructurally, the denatured mitochondria and endoplasmic reticulum were demonstrated within the pigmented granules and in the macrophages to suggest that pigments are of lipofuscin derivatives which originate from the denatured lipoprotein membranes of cytoplasmic organelles of injured colonic epithelial cells.
Burkitt's Lymphoma in Tonsil -A case report-
Ae Lan Paik, Sung Ran Hong, Seong Sook Kim, In Ki Paik, Ill Hyang Ko
Korean J Cytopathol. 1984;18(4):432-436.
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AbstractAbstract
Burkitt's Lymphoma was first descibed as "round cell sarcoma" in the jaw bone by Denis Burkitt in 1958. Although endemic in tropical Africa, it occurs in many other countries. Differences between African and non-African types include presenting sites of tumors, age at onset, frequency of late relapse after chemotherapy and association of Ebstein-Barr virus, but histologic features are identical. We report a case of Burkitt's lymphoma in tonsil where is relatively rare location with brief review of literatures.
Lymphangiomyomatosis of the Lung -A report of a case-
Mi-Kyung Jae, Ki-Hwa Yang, Byoung-Kee Kim, Sun-Moo Kim
Korean J Cytopathol. 1984;18(4):437-441.
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AbstractAbstract
Pulmonary lymphangiomyomatosis is a rare but distinct condition caused by progressive widespread smooth muscle proliferation in the perilymphatic regions throughout the lung. The disease is clinically manifested by recurrent chylous pleural effusion, pneumothoraxor ascites and striking female sex predominance. A relationship is noted between lymphangiomyomatosis and certain secondary lesions associated with tuberous sclerosis. The authors experienced a case of pulmonary lymphangiomyomatosis in 23 years old female patient who had been suffered due to recurrent pneumothorax for two weeks. During explorative thoracotomy, a huge cystic mass, 18.5×8.0×3.0 cm can and weighing 100gm, was noted in the lower lobe of the right lung. The external surface was tan brown and dirty with rubbery consistency. The inner surface was also tan brown and dirty with fibrous meshwork. Microscopically, there were varying sized cysts lined by flattened cuboidal cells. There were irregular and nodular proliferation of smooth muscle bundles in the wall of the cysts.
A Case Report of Pulmonary Leiomyosarcoma
Sun Hwa Jo, Dong Wha Lee, Duk Yong Kang
Korean J Cytopathol. 1984;18(4):442-446.
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AbstractAbstract
Leiomyosarcomas are very rare in lung. To date, several cases have been reported in literature since first discription in 1907, by Davidsohn. Pulmonary leiomyosarcoma is classified into primary and secondary forms. Primary from is known to be arisen from smooth muscle in the bronchi or blood vessles. The original sites of secondary pulmonary leiomyosarcoma are usually retroperitoneal soft tissue, gastrointestinal track or genitourinary track, especially uterus. We experienced a case of pulmonary leiomyosarcoma which was found in lower lobe of right lung from 40 years old man. Grossly, the tumor was a round shaped well circumscribed mass with rubbery hard consistency at the right lower lobe, measuring 7.5 cm in maximum diameter. The cut surfaces of the mass are somewhat lobulated, and show whorling pattern with focal necrosis and hemorrhage. Microscopically, the tumor is highly cellular and composed of interlacing bundles of spindle cells, which show moderate pleomorphism with motoses over 12/10 high power field. Electronmicroscopic examination reveal many numbers of microfilamants is in the cytoplasms of the tumor cells, which run parallel with longitudinal axis of the nuclei. The a report of a case and review of literature was discussed briefly.
Pseudocarcinomatous Invasion in Peutz-Jeghers Polyposis -Report of a Case-
Yong Il Kim*, Woo Ho Kim*, Dong Youb Suh, Kwi Hyun Cha, Sang Je다 Ahn, Chang Ok Park
Korean J Cytopathol. 1984;18(4):447-452.
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AbstractAbstract
Since and intestinal polyposis in association with mucocutaneous pigmentations was first observed by Peutz in 1921 and ten subsequent cases were added by Jeghers(1949), numerous cases have been cumulated under the designation of Peutz- Jeghers syndrome. Substantial portions of these causes were once described as having polyps with malignant changes microscopically shown in such cases, extraintestinal metastatic lesions occurred very rarely, and even some malignant cases with metastasis did not provide the solid evidence of carcinomas originating from the Peutz-Jeghers polyps. Thus, it is our purpose to present a case of Peutz-Jeghers polyposis manifested with peculial hitology of pseudocarcinomatous glandular and mucinous trapping and to discuss its nature with special emphasis on the differential diagnosis from the genuine malignant change of this polyp.
Anisakiasis in Terminal Ileum -A case report-
Ae Lan Paik, Sung Ran Hong, In Ki Paik, Ill Hyang Ko, Jin Lee*, In Wook Paik*, Nak Whan Paik*, Jong Yil Chai**
Korean J Cytopathol. 1984;18(4):453-456.
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AbstractAbstract
Anisakiasis is an infection in gastrointestinal track caused by the third stage of larvae family, Anisakidae. The diagnosis is made by the striking feature of larva showing cuticle, well developed musculature beneath the hypodermis, and two large Y-shaped lateral chords extending into the body cavity as well as large esophagus at the center. After several cases of anisakiasis were reported in Netherland by Van Theil, it was recognized that similar infections were occurring in Japan and Korea, which is closely related with the habit of raw eating of marine fishes. We report a case of anisakiasis involving terminal ileum with brief review of literatures.

JPTM : Journal of Pathology and Translational Medicine