Journal of Pathology and Translational Medicine

Volume 22(2); June 1988

Original Articles

A Histopathologic Study of Mammary Dysplasia.: Je G Chi, Chul Woo Kim, Yeon Lim Suh; Korean J Pathol. 1988;22(2):123-130.

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Abstract PDF: "Mammary dysplasia" and "fibroadenoma" represent almost all benign breast disease presenting with breast lumps. Mammary dysplasia comprises variable non-specific changes of stroma and epithelium, but fibroadenoma has been classified as a benign neoplasm, although both features not uncommonly coexist. Authors performed a blind microscopic review of 660 cases of benign breast lesions and the results are as followings. 1. Only 27.9% of all cases consisted of pure fibroadenoma in contrast to 57.5% in the original diagnosis. 2. Fibrocystic disease frequently contained foci of fibroadenoma showing varied stages (68.3%), and the younger age group presented more wide areas of fibroadenoma. 3. The most common feature of the fibrocystic disease was fibrosis, followed by cystic change, adenosis and epithelial hyperplasia in order of frequency. 4. Fibroadenoma may be a form of a spectrum produced by hormonal imbalance, and better classified as a nonneoplastic lesion.

Spinal Fluid Cytology of Retinoblastoma.: Je G Chi, Chul Woo Kim, Yeon Lim Suh; Korean J Pathol. 1988;22(2):123-130.

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Abstract PDF: Of all the primary central nervous system tumors, the medulloblastoma, glioblastoma multiforme, ependymoma and pineal germinoma tend to exfoliate in the cerebrospinal space. With all other types of the tumor, abnormal cells may seldom be definitely identified in the cerebrospinal fluid. Up to now the tumor cells have been rarely found in CSF cases of retinoblastoma. We have experienced a case of advanced retinoblastoma that showed exfoliated cells in spinal fluid.

Case Reports

Systemic Nocardiosis: An autopsy case.: Eun Sun Park, Kyo Young Lee, Sang In Shim, Sun Moo Kim; Korean J Pathol. 1988;22(2):131-137.

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Abstract PDF: Nocardia species are aerobic, gram-positive, acid-fast, filamentous branching bacilli. Nocardia is a localized or disseminated infection which may involve all tisuses and is produced by members of the genus Nocardia, principally N. asteroides. Other species, notably N. brasiliensis and N. caviae have been implicated, but N. asteroides appears to be the overwhelming predominant pathogen. Nocardial infections are usually opportunistic in the compromised host, at least 15% of the infections occurred in patients without a definable predisposing condition. Recently, we experienced an autopsy case of systemic nocardiosis. The patients was fiffty-three days old female infant, who had suffered from productive cough, dyspnea and fever. The patient was treated under the impression of the miliary tuberculosis, but she died at 34th hosital day. The postmortem examination reveals multiple tan gray colored abscess involving both lungs, both kidneys, and thymus. Microscopically, lung, kidney and thymus reveal multiple abscess, which are composed of necrotic tissue debris admixed with infiltrates of neutrophils, and they are surrounded by fibrosis, ad acute and chronic inflammatory cells. By histologic, microbiologic and biochemical studies, N. asteroides is identified in the lesion of the lung, kidney, thymus, and bronchial washing specimen.

Malignant Fibrous Histiocytoma of the Heart: A case report.: Mi Seon Lee, Kyu Sang Song, Kwang Sun Suh, Dae Young Kang, Young Lee; Korean J Pathol. 1988;22(2):138-144.

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Abstract PDF: A case of a 58-year-old man with malignant fibrous histiocytoma (MFH) of the right ventricle is reported light and electron microscopically. This is the first case of MFH of the heart in the Korean literature. A tendency for malignant fibrous histiocytoma of the heart to occur in the left atrium of young women is suggested; this sarcoma's usual location is in the soft tissue of elderly men. The tumor consisted of spindle cells arranged in a focal storiform patterns, clusters or sheets of histocyte-like cells, benign and malignant giant cells, inflammatory cells, scattered mitotic figures and anaplasia of stromal cells. In ultrastructure the constituent of cells of the tumor are primitive mesenchymal cells, histiocytoid cells and fibroblast like cells including giant cells.

Original Articles

Subglottic Laryngeal Atresia: Associated with Tracheoesophageal Fistula.: Gu Kang, Je G Chi; Korean J Pathol. 1988;22(2):145-147.

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Abstract PDF: A case of congenital laryngeal atresia of infraglottic type in a newborn infant is described for is rarity and importance of early diagnosis. This case was associated with tracheoesophageal fistula, and died in 5 minutes of life due to asphxia. Failure to intubate in the neonate should raise the possibility of laryngeal atresia and emergency management should be provided. The lung tissue was normally developing despite the complete obstruction of the outlet of the air and possible amniotic fluid passage.

Gastric Duplication.: Hee Na Kim, Chang Seok Kang, Sang In Shim, Sun Moo Kim; Korean J Pathol. 1988;22(2):148-153.

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Abstract PDF: Gatric duplication is a rare congenital anomaly. Thus for about 90 cases of gastric duplication have been recorded in the literature. It is less frequent than small intestinal or eosphageal duplication, and accounts for only 3.8% of all gastrointestinal tract duplication. Most gastric duplications are seen during the first year of life. Palpable abdominal mass and gastric outlet obstruction in infancy are most common presentation. We experienced a case of non-communicating gastric duplication. A 12-year-old girl visited St. Mary's Hospital because of indigestion, intermittent vomiting, and left upper quandrant pain for about 40 days. She have had intemittent abdominal pain with concomitant increased level of amylase since 5 years old. Physical examination showed a hen's egg sized palpable mass on left upper quadrant of the abdomen. Upper GI series and barium enema revealed only indentation of duodenal C-loop, and sonogram and abdominal CT demonstrated isolated cystic mass along the greater curvature of gastric antrum. She had taken an operation under the impression of pancreatic pseudocyst. Operation revealed a cystic mass, located along the greater curvature. There was no pathologic change in the pancreas. Microscopic findings of the cyst wall revealed normal gastric mucosal lining and common muscle layer, shared with gastric antral muscle layer.

Intestinal Anisakiasis.: Gyung Hyuck Ko, Cheol Keun Park, Hun Joo Kong, Chun Sik Choi, Sang Hoon Lee, Sung Jong Hong; Korean J Pathol. 1988;22(2):154-158.

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Abstract PDF: We reported 3 cases of intestinal anisakiasis. The patients had abdominal pain, nausea or vomiting, after eating raw sea-fishes 1 to 5 days before. Intestinal resection was performed under the impression of mechanical obstruction or cancer. The resected intestines showed marked edema, congestion or hemorrhage in the mucosa. Microscopically the larvae were found in the submucosa or inner muscle layer, and surrounded by phlegmonous inflammation with intense eosinophilic infiltration. The larvae were identified as Anisakis spp. by multiple sections.

Disseminated Deciduosis Peritonei.: Moon Hyang Park, Chan Kum Park, Jung Dal Lee; Korean J Pathol. 1988;22(2):159-163.

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Abstract PDF: Gross deciduosis in pregnancy is rare. A case of disseminated deciduosis peritonei studied by light and transmission electron microscopy is reported. The pathogenesis of deciduosis peritonei and relationship with leiomyomatosis peritonealis disseminata are discussed in view of the present findings and those previously reported.

Case Reports

Paraganglioma of the Urinary Bladder: A case report.: H K Lee, K M Lee, D K Chung; Korean J Pathol. 1988;22(2):164-168.

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Abstract PDF: We herein report a case of paraganglioma arising from the urinary bladder in a 67-year-old woman. Her chief complaint was gross hematuria. However, she didn't manifest any other catecholamine-associated symptoms such as hypertension, palpitation and micturitional attack. Grossly, the tumor revealed bilobular external appearance with foci of ulceration and hemorrhage. The cut surface showed pinkish yellow homogeneous soft tissue. Microscopically, the tumor was composed of polygonal cells with basophilic granular plump cytocopic study, numerous membrane-bound electron dense granules were noted in the cytoplasm.

Malignant Mixed Mesodermal Tumors of Ovary: 3 cases report.: Dong Won Kim, Tae Jung Kwon, Dong Wha Lee; Korean J Pathol. 1988;22(2):169-179.

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Abstract PDF: Malignant mixed mesodermal tumor (MMMT) of the ovary is endometrioid tumor containing epithelial and mesenchymal components. The mesenchymal component may be homologous, in which case the term carcinosarcoma is often used, or heterologous, containing cartilage, striated muscle, osteoid, bone, or fat, or combination of these elements. MMMT usually afflicts the postmenopausal woman and occurs more often in the nulliparous female. The disease is usually advanced (stage III) when diagnosed. Cliniopathologic data were presented for 3 cases of MMMT of the ovary with review of literatures. Clinical history substantiated previous reports in postmenopausal women wit this tumor. Symptoms were the same as for ovarian malignancy in general. All the patients presented wit stage II disease, according to the International Federation fo Gynecology and Obstetrics (FIGO) classification. Two patients died of tumor 4 and 10 months after operation, respectively. One patient had been alive at 2 months after operation. None of 3 cases demonstrate evidence of endometriosis in the remaining ovaries. Microscopically, periodic acid-Schiff (PAS)-positive, diastase-resistant hyaline droplets were found frequently in undifferentiated mesenchymal stroma and epithelial structures. The clinical significance and origin of the hyaline droplets in MMMT should be further explored.

Clear Cell Hidradenoma: A report of five cases.: Mi Kyung Jee, Seok Jin Gang, Byung Kee Kim, Sun Moo Kim; Korean J Pathol. 1988;22(2):180-189.

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Abstract PDF: The clear hidradenoma, generally regarded as an eccrine sweat gland origin, is an uncommon tumor and occurs as a slowly growing, usually solitary nodule. The histologic patterns varies from one tumor to another and in different parts of the same tumor. The histologically variable patterns, therefore, are expressed in various names, including nodular hidradenoma, eccrine acrospiroma, squamous poroadenoma, and solid cystic hidradenoma. During the past 16 years the authors experienced 5 cases of clear cell hidradenoma which were diagnosed by the histopathological examination of the tumor mass removed by surgical excision. Clinical and pathological features were reviewed and the following results were obtained. 1) The mean age was 34 years with a range from 27 to 45 years. Three were male and two female. 2) The chiefr complaint was intradermal or subcutaneous nodules for a period of several years to 15 years. All cases occured as a solitary nodule without a distinct predilection for certain sites. A nodule which situated in the dermis and was accompanied by superficial ulceration was elevated above the skin surface in one case. 3) Grossly, the tumors were relatively well circumscribed and composed of multiloblated masses in 4 cases. They ranged in size between 1.5 and 3.5 cm. 4) Microscopically, all cases disclosed lobulated solid masses separated by varying amounts of collagenous connective tissue. There were often cystic spaces, which were lined by a single row of cuboidal cells in four cases and were bordered by tumor cells in remaining one case. These cysts contained a faintly eosinophilic homogeneous material. On solid portions of the tumor there were two types of cells (clear cell and polygonal cell), the proportions of which varied from tumor to tumor in three cases. The remaining two cases were predominantly composed of clear cells. Tubular lumina which were lined by cuboidal or columnar ductal cells were found in two cases. Areas of squamous differentiation and squamous eddies were seen in one case. Intracytolasmic PAS-positive materials were shown in all cases, but diastase-resistant PAS materials in two cases.

Nodular fasciitis (13 cases analysis).: Jung Ran Kim, Je G Chi; Korean J Pathol. 1988;22(2):190-194.

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Abstract PDF: Nodular fasciitis is a rare and benign soft tissue tumor that can easily confused microscopically to spindle cell sarcoma. Therefore it is very important disease to the surgical pathologists. However, this lesion has been seldom reported or described in Korean literature. This paper deals with 13 Korean cases of nodular fasciitis diagnosed microscopically. It's pertinent clinicopathologic findings are described. The youngest patients among 13 cases was 18 years and the oldest was 63 years with the mean of 34 years. Nine were males and 4 were females. Pathologically, the size of the lesion at the time of diagnosis ranged from 0.7 cm to 4.0 cm in the maximum extent. Two were smaller than 1.0 cm and 8 cases were between 1.0~3.0 cm. The site distibution was; trunk(5) upper extremitiy (4), lower extremity (2) and head (2). All the lesions were located in the subcutaneous tissue. The history of recent rapid growth was noted in nearly half of the cases. Mass and tenderness were two common manifestations. In one case, multiple nodules were found in the right breast and in flank. All of the lesions except one were managed by local excision. In one case, a wide excision was done under the impression of malignant fibrous histiocytoma of frozen section. Follow up observation of all cases did not show any evidence of recurrence in all.

Original Article

Extraskeletal Ewing's Sarcoma.: Gui Ohk Yoon, Hae Kyung Ahn, Ill Hyang Ko; Korean J Pathol. 1988;22(2):195-198.

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Abstract PDF: A case of extrastkeletal Ewing's sarcoma on lower extremity in a 60-year-old male is reported. Extraskeletal Ewing's sarcoma is a rare malignant neoplasm that shows similar histologic and ultrastructural features to Ewing's sarcoma of bone. Histologically, the neoplasm was composed of small, round to oval cells with scant cytoplasm that were arranged in sheets with large area of necrosis. Electron microscopy of the neoplastic cells revaled scant cytopasm containing glycogen rosettes and a paucity of organelles. There is no ultrastructural evidence to indicate the origin of the cells.

Case Reports

Porencephaly: An Autopsy Case Report.: In Sook Kim, Jin Hee Shon, Hyo Sook Park, Je Geun Chi; Korean J Pathol. 1988;22(2):199-203.

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Abstract PDF: Porencephaly is a rare congenital anomaly characterized by a cavitary hole extending from the cerebral mantle to the ventricle of the brain and covered by leptomeningeal membrane. It is now generally believed that the porencephaly represents a fetal or neonatal destructive process of the neural tissue. Authors experienced an autopsy case of bilateral porencephaly in a 35-day-old Korean male infant who died of sepsis. The brain weighed 150 gms and morphologically well formed except for two large symmetric defects at the fronto-parietal region. These defects were characterized by cleft-like shape, covering the entire cerebral mantle with resultant direct communication between ventricular cavity and leptomeninges. Thin leptomeningeal trabeculae were covering the cavity. There was a smooth transition between ependyma and roof of the defects. There are focal, microscopic cerebral infarct and abscess without connection with the cavitary lesion. The remaining central nervous system was unremarkable.

Intracranial Lipoma: A case report.: Young Dae Kim, An Hi Lee, Sun Moo Kim; Korean J Pathol. 1988;22(2):204-207.

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Abstract PDF: Lipoma involving brain and spinal cord is a rare tumor that most commonly located in the midsagittal region. This lesion is usually asymptomatic and has been reported incidentally at postmortem examination. Recently, the CT scan establishes the diagnosis of intracranial lipoma on the basis of typical X-ray absorption and location. The authors experienced a case of intracranial lipoma of occipital lobes. The patient was 7 months-old male who had protruding mass on the occipital region after birth. The mass revealed an uncapsulated lipoma with foca cartilage formation. We report this case with brief review of literatures.

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