Journal of Pathology and Translational Medicine

Volume 22(4); December 1988

Original Articles

Squamous Cell Carcinoma Arising in Burn Scar.: S P Hong, S S Lee, J M Chae, E S Chang, C H Chung; Korean J Pathol. 1988;22(4):360-366.

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Abstract: Treves and Pack in 1930 estimated that about 2% of burn scars undergo malignant change and they found that these usually occurred in the extremities and scalp. Males outnumber females in a ratio of 3 to 1 in burn scar cancers and all races have developed such tumors. Lawrence in 1952 accepted only 99 cases of burn scar cancer in his review but it seems certain that these are considerably commoner than this figure would indicate. These cancers are usually squamous in type and almost always arise in large deep burn scars which were never grafted and were slow to heal. A few basal cell carcinomas have been reported in more superficial scars usually on the face or neck. A few cases of fibrosarcoma have been reported also but here the differential diagnosis of so-called spindle-cell squamous carcinoma is always present. Recently Sarma and Weilbaecher reported a case of squamous cell carcinoma arising in a burn scar in an amputation stump was reported. Authors experienced 13 cases of burn cancer and the clinico-pathologic charateristics were reviewed.

Immunohistochemical Observation on the Plasma Cells Secreting Specific and Non-specific Anti-body to Parasite in Soft Tissue Cysticercosis.: Eon Sub Park, Suk Il Kim, Kye Yong Song; Korean J Pathol. 1988;22(4):367-374.

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Abstract PDF: In order to elucidate the possibility of diagnosis in soft tissue cysticercosis in case no parasite in it, immunohistochemical staining with antihuman IgG, IgM, and IgA and anticysticercus antibody in tissue section were carried out. Not only the differential counts of infiltrated plasma cells but also the parasite itself against to the anticysticercus antibody were observed. Materials stained immunohistochemically were consisted of 21 soft tissue cysticercosis with or without parasite. The results were as follows: 1) IgG producing plasma cells were most frequent (45.8+/-18.7) and followed by IgM (14.3+/-0.43) and (4.3+/-5.71). Number of IgG plasma cells were more frequently accompanied in the presence of cysticercus (55.9+/-17.7) than in the absence of parasite (39.7+/-17.1). 2) The mean+/-S.D. of plasma cells positive to the anticysticercus antibody were 28.2+/-18.7. And anticysticercus antibody producing plasma cells were more frequent in the presence of cysticercus (49.2+/-5.16) than in the absence of parasite (15.2+/-9.46). 3) Antigenicity of the cysticercus was strong in inner layer(#) followed by tegument(+) and fibrous layer(-). 4) Therefore, it could be suggested that antibody against to the cysticercus is mainly produced by IgG plasma cells and antigenicity of the worm is strong in the inner layer of cyst wall. In addition, there is a possibility of assisting the diagnosis of cysticercosis with anticysticercus antibody by immunohistochemically.

Two Patterns of Gastric Carcinoma with Lymphoid Stroma.: Gu Kang, Eun Sil Yu, Yong Il Kim; Korean J Pathol. 1988;22(4):375-382.

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Abstract PDF: Various clinical and pathologic parameters in order to determine the prognosis of gastric carcinoma have been proposed. Among them "carcinoma with lymphoid stroma" has been proven to show good prognosis. But the criteria of lymphoid stroma in this condition remain vague and not clear. A total of 7 cases of gastric carcinoma with heavy lymphoid stromal response out of 947 surgically resected gastric carcinomas was reviwed with histotopographic analysis. They were all advanced carcinoma, Borrmann type I and II. Histologically, the lymphoid stromal response could be divided into three patterns; nodular (3 cases), diffuse (3 cases) and mixed (1 case). The nodular pattern was characterized by massive lymphoid cell infiltration with many follicle formation and little desmoplastic reaction, while the diffuse pattern showed diffuse permeative type of inflammatory cell infiltration with scarce lymphoid follicle formation and mild desmoplasia. Regional lymph node metastasis was found in 2 cases; one in diffused and another one in mixed pattern. The stromal reaction was not directly related with the depth of tumor invasion. We propoose that the term GCLS should be used in the cases of nodular pattern with complete follicle formation of lymphoid stroma.

An Experimental Study of Pathogenesis of Duodenal Ulceration Produced by Mepirizole.: Myung Jae Kang, Jae Ryong Jung, Hye Soo Lee, Sang Ho Kim; Korean J Pathol. 1988;22(4):383-392.

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Abstract PDF: To investigate the pathogenesis of the duodenal ulceration produced by mepirizole (1-(4-methoxy-6-methyl-2-pyrimidinyl)-3-methyl-5-methoxypyrazole) in rat, the effects of various concentraion and sorts of antiulcer drugs and truncal vagotomy on the mepirizole (200 mg/kg of body weight) induced duodenal ulcers were observed morphologically, and after mepirizole administration (200 mg/kg), amount and acidity of gastric jucie were measured sequently. The results were as follows: 1) In the control group of fasting for 24 hours after mepirizole administration only, duodenal ulcers were developed in all animals with 21.5+/-5.8 mm2 of ulcer index, perforation rate was 15%, and mortality rate was 0%. But lesions of the stomach were hemorrhagic and erosive with erosion index of 3.8+/-1.6 mm2. 2) The antiulcer drugs were significantly inhibited duodenal ulceration and gastric erosion produced by mepirizole although the inhibition effects were different. 3) After truncal vagotomy, duodenal ulcer and gastric erosion induced by mepirizole were also significantly inhibited. 4) On the gastric analysis, decrease of amount, increase of acidity, and decrease of concentration of gastric juice were observed after administration of mepirizole compared with nontreated normal group. Above findings suggest that the pathogenesis of the duodenal ulceration by mepirizole is the action of gastric acid on the duodenal mucosa with breakdown of defence mechanisms of the duodenum.

A Clinicopathologic Study on Chronic Alcoholic Hepatitis.: Gi Yeong Huh, Sun Kyung Lee; Korean J Pathol. 1988;22(4):393-403.

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Abstract PDF: This study was undertaken to evaluate the significant diagnostic points of chronic alcoholic hepatitis (CALH) among clinicopathologic findings observed. The specimens used in this study were 20 cases of CALH and 28 cases of chronic active viral hepatitis (CAVH), which were diagnosed at our University Hospital during 9 years period from 1978 to 1987. In these cases, comparative analysis of age and sex distribution, major clinical manifestations, and laboratory and histopathologic findings was performed. The results obained were summarized as follows: Among 20 cases of CALH, the sex distribution was 15 in male and 15 in female with a ratio of 3:1. The range of age distribution was wide from third to seventh decade. There was no recognizable special point about the age and sex distribution of CALH, compared with cases of CAVH. Major clinical manifestations of CALH were hepatomegaly (85%), jaundice (75%) and abdominal pain (50%). Also there was no recognizable special point about the major clinical manifestations of CALH, compared with cases of CAVH. Abnormal values of major laboratory items in CALH were observed in activities of serum r-GTP (100%), SGOT (95%), SGPT (75%) and serum alkaline phosphatase (60%), and total serum bilirubin (60%). Compared with CAVH in major laboratory findings, the significant diagnostic items of CALH were the activities of serum r-GTP and alkaline phosphatase. The characteristic histopathologic findings of CALH, which were compared with CAVH and observed in liver parenchyma, were fatty change (100%), cytoplasmic ballooning and coagulation (100%), delicate fibrosis (85%), bile stagnation (35%), and Mallory bodies (20%), and that observed blurring of limiting plate (60%) in portal and periportal areas.

Occurrence of Hepatitis B-Virus Antigens in a Consecutive Material of 112 Liver Biopsies.: S P Kim, C H Kim, S S Lee, C H Chung; Korean J Pathol. 1988;22(4):404-414.

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Abstract PDF: The frequency and occurrence of HBsAg and HBcAg in 112 consecutive, HBsAg sero-positive, liver biopsies were determined using immunoperxidase staining, HBsAg and HBcAg were demonstrated in 35 (31.3%) and 71 (63.4%) biopsies, respectively. HBsAg in liver was found in the cytoplasm as diffuse granules, mostly in the form of cytoplasmic inclusions. There was also perinuclear and membranous patterns. HBcAg in liver was found mostly in the cytoplasm and occasionally confined to the nucleus. The highest correspondence between HBsAg positivity in serum and liver was found in cases with normal histology morphology (80%). The frequency of HBs and HBcAg in liver in chronic liver disease was 23.1~50% and 36.4~69.2%. According to the variable expression pattern of HBs & c Ags in liver cells, 47 cases (42%) showed only HBcAg in liver. Twenty-nine cases (25.6%) failed to demonstrate any HBV Ags in liver and 24 cases showed boty antigens in liver. No correlation was found between liver disease groups and HBV Ag expression patterns. However, 11 cases (9.8%) showed only HBsAg in liver; predominant HBsAg pattern was observed in 80% of "normal histology group". 73.2% of HBsAg positive patients had anti-HBc in serum and 57.7% of them had HBeAg. 70.3% of anti-HBc positive and 70.7% of HBeAg sero-positive patients had HBcAg in liver cells. These findings strongly suggest that the presence of HBcAg. Serum HBeAg and anti-HBc can be used as a reliable indicator of active viral replication. The overall results further suggest an interplay of both hepatitis B virus and host immune response in the development and pathogenesis of hepatitis, including different degrees of accumulation of HBsAg and HBcAg in the liver and the various histological types of hepatitis.

Case Report

Adrenocortical Adenoma: A report of 7 Cases.: Mi Seon Lee, Dae Hyun Baek, Kwang Sun Suh; Korean J Pathol. 1988;22(4):415-423.

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Abstract PDF: Primary tumors of the adrenal cortex are comparatively rare. In the medical literature they are most frequently reported as single case. Because of their infrequent occurence some features of their clinical behavior and pathologic anatomy are not widely known. For this reason the recording of the 7 cases from the Department of Pathology, School of Medicine, Chungnam National University is thought to be worth while. Of the seven tumors, five were associated with primary aldosteronism, one Cushing's syndrome, and the remaing one virilizing syndrome. All were benign. Females were affected more frequently than males. Adrenocortical adenomas tend to be small, weighing less than 42 gm. The tumors associated with primary aldosteronism were composed of zona fasciculata-like cells and "hybrid" cells. The tumor with Cushing's syndrome consisted of zona reticularis-like cells. The tumor with virilizing syndrome consisted of zone reticularis-like cells.

Original Articles

An Experimental Study of DMBA (9,10-Dimethyl-1,2-Benzanthracene) Induced Knee Joint Tumors in the Rats.: Myung Jae Kang, Dong Geun Lee, Sam Im Choi, Sang Ho Kim; Korean J Pathol. 1988;22(4):424-434.

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Abstract PDF: For the morphological analysis of DMBA (9,10-diemethyl-1,2-benzanthracene) induced tumor, thirty Sprague-Dawley rats were received 0.1 ml of a 2% paraffin solution of DMBA into the knee joint cavity, which was repeated three times at an interval of 4 weeks. The induced tumor masses were removed at the 12th week after the first injection. Histological and histochemical examinations (H & E, PAS, alcian blue, Van Gieson, prussian blue, reticulin, PTAH stain) and enzyme histochemical examinations (acid phosphatase, alkaline phosphatase, alpha-naphthyl acetate esterase) were performed. The results were as follows: 1) By the 12th week after the first injection of DMBA, the tumor incidence rate was 20 percent. 2) On histological and histochemical examination, most of the induced tumor disclosed the features of the fibrous histiocytoma originating from mesenchymal cells, and the remains sweat gland adenoma and adenocarcinoma originating from epithelial cells. 3) On enzyme histochemical examination, most of the mesenchymal cell-derived tumor cells showed positive reactions for acid phosphatase and alpha-naphthyl acetate esterase, which were similar characteristic features of enzyme stains as shown in the component cells of fibrous histiocytoma.

Histopathological Analysis of 9 Cases of Plexiform Schwannoma.: Nam Hoon Cho, Jung Hoon Yoon, Hyeon Joo Jeong; Korean J Pathol. 1988;22(4):435-439.

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Abstract PDF: We present 9 cases of plexiform schwannoma examined at Severance hospital from January, 1980 to September, 1987. The predilection sites of plexiform schwannoma included head and neck including oral cavity. The mean age at the time of diagnosis was 32 years. The difference of sex ratio was not apparent. Histopathological findings revealed multiple round to oval nodules encapsulated by thin fibroconnective tissue with nuclear palisading and Verocay body in each nodule. There was mild to moderate cellular atypia in some area, but mitotic figure was not found. The Bielschowsky's silver stain did not demonstrate any axon within or outside of the nodule. The thin capsule was positive with reticulin stain.

Case Report

A Case of Esophageal Granular Cell Tumor.: Mi Kyung Kim, Eun Sup Park, Kye Yong Song, Sil Moo Park; Korean J Pathol. 1988;22(4):440-442.

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Abstract: Esophageal granular cell tumor of is rare neoplesin, and 3 cases were reported in Korea so far. We report a case of esophageal granular cell tumor in a 28 year old man. The patient was a 28 year old man who visited this hospital because of upper abdominal pain, acid belching and weight loss. A small nodule, 5 mm in diameter, was found in mid esophagus on esophagoscopy. This nodule was proved to be a granular cell tumor.

Original Articles

Medullary Carcinoma of Thyroid Gland with Co-existing Papillary Carcinoma.: Jeong Hee Ahn, So Yong Jin, Ho Guen Kim, Chan Il Park; Korean J Pathol. 1988;22(4):443-447.

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Abstract PDF: We report a medullary carcinoma of the thyroid gland with a coexisting occult sclerosing papillary carcinoma. This rare case, in that the two types of carcinoma are completely separated and not intermixed together, is different from the previously reported mixed follicular and parafollicular cell carcinomas of the thyroid gland, so-called "differentiated thyroid carcinoma, intermediate type". The two separate tumors of the present case are undoubtedly of coincidental double primaries, and it can be a assumed that at least some of the mixed follicular and parafollicular cell carcinomas are results of collision of carcinomas derived from two embryogenetically different cell types.

Primary Signet Ring Cell Carcinoma with Widespreand Metastasis.: Nam Hoon Cho, Soon Hee Jung, Tae Sung Kim; Korean J Pathol. 1988;22(4):448-455.

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Abstract PDF: We present an autopsy case of signet ring cell carcinoma of urinary bladder which underwent widespread metastsis through nearly entire organ. The patient, 45-year old male, suffered from hematuria, dysuria and flank pain for 6 months. Under the diagnosis of the signet ring cell carcinoma by the cystoscopic biopsy, radical cystectomy and ileocutaneous ureteral division were performed. But he died after 11-months after the diagnosis. The autopsy confirmed the widespread metastasis at the lung, kidney, adrenal gland, parathyroid gland, heart, stomach, ileum, spine, rib and meninges. The preveously resected urinary bladder discolosed the well defined fungating mass at the dome and anterio-lateral portion without apparent evidence of the remnant of the urachus. Histologically, the signet ring cells were predominent and focally mucinous pool floating the signet ring cells was noted. We could find several foci of the well differentiated adenocarcinoma and poorly differentiated adenocarcinomas. The above findings may reflect that the origin of carcinoma may be from the multipotential transitional cell epithelium.

Case Reports

Adenocarcinoma of Urinary Bladder: 2 cases report.: Ki Kwon Kim, Eunk Sook Chang, Chai Hong Chung; Korean J Pathol. 1988;22(4):456-461.

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Abstract PDF: Two cases of adenocarcinoma of the urinary bladder with clinical and pathological features, and brief review of the literatureare presented. Case 1: The patient, a 52 year-old man, was admitted to this hospital because of intermittent painless total gross hematuria for 15 years. Cystoscopy was done, and showing a cauliflower mass with broad based diffuse infiltrating lesion at the right anten or portion of bladder. TUR-B was performed. Microscopically, the lesion consisted of colonic metaplastic epithelium with atypical glands and cystic dilatation and adenocarcinoma. Case 2: The patient, a 52-year-old woman, was admitted to this hospital because of total painless gorss hematuria for 1 year. Cystoscopy was done showing a sessile diffuse mass with ulceration on the dome area. Total cystectomy was performed. Grossly, the tumor showed an ulcerative tumor mass with elevated nodular margin at the dome of the bladder. Microscopically, the lesion consisted of anaplastic glands with back to back arrangement and branching glands through the entire thickness of the bladder wall.

Buerger's Disease of Paratesticular Tissue: A case report.: Soo Im Choi, So Young Jin, Chan Il Park; Korean J Pathol. 1988;22(4):462-466.

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Abstract PDF: We report a case of Buerger's disease manifested by a scrotal mass, in view of its rarity. A tender bean sized mass was palpated in the left scrotum of a 34 year-old male heavy smoker, who had a history of right pain two years ago which subsided spontaneously. The left testis with the paratesticular tissue was excised. Vessels of the spermatic cord and epididymis showed microscopic changes of Buerger's disease. The involved arteries and veins revealed a predominantly subacute pattern with granulomatous inflammation and Langhans' type giant cells within the thrombi.

Original Article

Simple Cyst Occurred in an Accessory Ovary.: Soon Won Hong, Kyu Rae Kim, Chan Il Park; Korean J Pathol. 1988;22(4):467-470.

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Abstract PDF: The accessory ovary can be defined as an extraovarian tissue that is located near the normal ovaries and is connected to the broad ligament, infundibulopelvic ligament or utero-ovarian ligament. It has very rarely been reported. The majority was found during abdominopelvic surgeries for any other purposes, because they were usually small and less than 1 cm in diameter adn gave no particular symptoms related simply to their presence. We reported a case of accessory ovary in which developed a simple cyst of a largest diameter of 12 cm, and discussed the significance of the accessory ovary in clinical and pathological aspects.

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