Journal of Pathology and Translational Medicine

Volume 48(5); October 2014

Original Articles

Histologic Disorderliness in the Arrangement of Tumor Cells as an Objective Measure of Tumor Differentiation: Sungwook Suh, Gyeongsin Park, Young Sub Lee, Yosep Chong, Youn Soo Lee, Yeong Jin Choi; Korean J Pathol. 2014;48(5):339-345. Published online October 27, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.5.339

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Abstract PDF: Background: Inter-observer and intra-observer variation in histologic tumor grading are well documented. To determine whether histologic disorderliness in the arrangement of tumor cells may serve as an objective criterion for grading, we tested the hypothesis the degree of disorderliness is related to the degree of tumor differentiation on which tumor grading is primarily based. Methods: Borrowing from the statistical thermodynamic definition of entropy, we defined a novel mathematical formula to compute the relative degree of histologic disorderliness of tumor cells. We then analyzed a total of 51 photomicrographs of normal colorectal mucosa and colorectal adenocarcinoma with varying degrees of differentiation using our formula. Results: A one-way analysis of variance followed by post hoc pairwise comparisons using Bonferroni correction indicated that the mean disorderliness score was the lowest for the normal colorectal mucosa and increased with decreasing tumor differentiation. Conclusions: Disorderliness, a pathologic feature of malignant tumors that originate from highly organized structures is useful as an objective tumor grading proxy in the field of digital pathology.

Mdm2 and p53 Expression in Radiation-Induced Sarcomas of the Head and Neck: Comparison with De Novo Sarcomas: Min Jeong Song, Joon Seon Song, Jong-Lyel Roh, Seung-Ho Choi, Soon Yuhl Nam, Sang Yoon Kim, Sung Bae Kim, Sang-wook Lee, Kyung-Ja Cho; Korean J Pathol. 2014;48(5):346-350. Published online October 27, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.5.346

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Background: The pathogenesis of radiation-induced sarcomas (RISs) is not well known. In RIS, TP53 mutations are frequent, but little is known about Mdm2-p53 interaction, which is a recent therapeutic target of sarcomas. Methods: We studied the immunohistochemical expression of Mdm2 and p53 of 8 RISs. The intervals between radiation therapy and diagnosis of secondary sarcomas ranged from 3 to 17 years. Results: Mdm2 expression was more common in de novo sarcomas than RISs (75% vs 37.5%), and p53 expression was more common in RISs than in de novo cases (75% vs 37.5%). While half of the RISs were Mdm2(–)/p53(+), none of de novo cases showed such combination; while half of de novo sarcomas were Mdm2(+)/p53(–), which are a candidate group of Mdm2 inhibitors, only 1 RIS showed such a combination. Variable immunoprofiles observed in both groups did not correlate with tumor types, except that all of 2 myxofibrosarcomas were Mdm2(+)/p53(+). Conclusions: In conclusion, we speculated that both radiation- induced and de novo sarcomagenesis are not due to a unique genetic mechanism. Mdm2- expression without p53 overexpression in 1 case of RIS decreases the future possibility of applying Mdm2 inhibitors on a subset of these difficult tumors.

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Radiation-Induced Sarcomas of the Head and Neck: A Systematic Review
Andrés Coca-Pelaz, Antti A. Mäkitie, Primož Strojan, June Corry, Avraham Eisbruch, Jonathan J. Beitler, Sandra Nuyts, Robert Smee, Johannes A. Langendijk, William M. Mendenhall, Cesare Piazza, Alessandra Rinaldo, Alfio Ferlito
Advances in Therapy.2021; 38(1): 90. CrossRef
Genomic Characterization of Radiation-Induced Intracranial Undifferentiated Pleomorphic Sarcoma
Christopher S. Hong, Edwin Partovi, James Clune, Anita Huttner, Henry S. Park, Sacit Bulent Omay, Balraj Mittal
Case Reports in Genetics.2021; 2021: 1. CrossRef
Radiation-Induced Sarcoma of the Head and Neck: A Review of the Literature
Lorenzo Giannini, Fabiola Incandela, Marco Fiore, Alessandro Gronchi, Silvia Stacchiotti, Claudia Sangalli, Cesare Piazza
Frontiers in Oncology.2018;[Epub] CrossRef

Preparation of Compact Agarose Cell Blocks from the Residues of Liquid-Based Cytology Samples: Suk Jin Choi, Yeon Il Choi, Lucia Kim, In Suh Park, Jee Young Han, Joon Mee Kim, Young Chae Chu; Korean J Pathol. 2014;48(5):351-360. Published online October 27, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.5.351

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Background: Inevitable loss of diagnostic material should be minimized during cell block preparation. We introduce a modified agarose cell block technique that enables the synthesis of compact cell blocks by using the entirety of a cell pellet without the loss of diagnostic material during cell block preparations. The feasibility of this technique is illustrated by high-throughput immunocytochemistry using high-density cell block microarray (CMA). Methods: The cell pellets of Sure- Path residues were pre-embedded in ultra-low gelling temperature agarose gel and re-embedded in standard agarose gel. They were fixed, processed, and embedded in paraffin using the same method as tissue sample processing. The resulting agarose cell blocks were trimmed and represented on a CMA for high-throughput analysis using immunocytochemical staining. Results: The SurePath residues were effectively and entirely incorporated into compact agarose cell buttons and embedded in paraffin. Sections of the agarose cell blocks revealed cellularities that correlated well with corresponding SurePath smears and had immunocytochemical features that were sufficient for diagnosis of difficult cases. Conclusions: This agarose-based compact cell block technique enables preparation of high-quality cell blocks by using up the residual SurePath samples without loss of diagnostic material during cell block preparation.

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Brain-Derived Neurotrophin and TrkB in Head and Neck Squamous Cell Carcinoma
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Case Studies

Alveolar Soft Part Sarcoma of the Uterine Cervix: A Case Report and Review of the Literature: Hyun Ju Lee; Korean J Pathol. 2014;48(5):361-365. Published online October 27, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.5.361

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Alveolar soft part sarcoma (ASPS) of the uterine cervix is a rare malignancy, and 21 cases have been reported the literature from every language (including our case). Herein, we describe a 17-yearold female patient who presented with active vaginal bleeding. Pelvic examination revealed a 1.6 ×1.0×0.5-cm-sized soft mass protruding from the uterine cervix. The final pathological diagnosis was ASPS of the uterine cervix. Immunohistochemically, tumor cells were strongly nuclear positive for transcription factor E3. The patient remained disease free for 24 months without adjuvant therapy. The prognosis of ASPS in the cervix is considerably better than that of ASPS in soft tissues due to early clinical detection, small size, and resectability. ASPS should be considered in the differential diagnosis of an unusual epithelioid neoplasm showing organoid appearance with mild cytologic atypia and no/rare mitotic figures, particularly in young women. Pathologists should be aware of those unusual locations where ASPS may originate.

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Nodular Fasciitis of the Parotid Gland, Masquerading as Pleomorphic Adenoma: Chung Su Hwang, Chang Hun Lee, Ahrong Kim, Nari Shin, Won Young Park, Min Gyoung Park, Do Youn Park; Korean J Pathol. 2014;48(5):366-370. Published online October 27, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.5.366

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It is difficult to distinguish nodular fasciitis (NF) from other neoplasm of the parotid gland, especially pleomorphic adenoma (PA) by fine needle aspiration cytology. A 39-year-old female noticed a mass in the parotid region. The aspirate material showed cohesive parts composed of the cells that had oval or spindle-shaped nuclei and relatively abundant cytoplasm and some cells with plasmacytoid features. The background substance was fibromyxoid. PA was diagnosed based on the cytologic findings. Subsequently, parotidectomy was performed and NF was diagnosed based on histologic and immunohistochemical findings. NF in the parotid region is rare and may be misdiagnosed as other benign or malignant tumors of the parotid gland. The clinical history of rapid growth and the presence of mitoses and inflammatory cells help to distinguish NF from PA. In addition, immunohistochemical stains for smooth muscle actin and CD68 are useful to confirm the diagnosis of NF.

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Brief Case Reports

Cystic Brunner’s Gland Hamartoma in the Gastric Body: A Case Report: Dong Hae Chung, Na Rae Kim, Hyun Yee Cho, Yoon Jae Kim; Korean J Pathol. 2014;48(5):371-374. Published online October 27, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.5.371

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