Journal of Pathology and Translational Medicine

Reviews

Professional biobanking education in Korea based on ISO 20387: Jong Ok Kim, Chungyeul Kim, Sangyong Song, Eunah Shin, Ji-Sun Song, Mee Sook Roh, Dong-chul Kim, Han-Kyeom Kim, Joon Mee Kim, Yeong Jin Choi; J Pathol Transl Med. 2025;59(1):11-25. Published online January 15, 2025; DOI: https://doi.org/10.4132/jptm.2024.11.04

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To ensure high-quality bioresources and standardize biobanks, there is an urgent need to develop and disseminate educational training programs in accordance with ISO 20387, which was developed in 2018. The standardization of biobank education programs is also required to train biobank experts. The subdivision of categories and levels of education is necessary for jobs such as operations manager (bank president), quality manager, practitioner, and administrator. Essential training includes programs tailored for beginner, intermediate, and advanced practitioners, along with customized training for operations managers. We reviewed and studied ways to develop an appropriate range of education and training opportunities for standard biobanking education and the training of experts based on KS J ISO 20387. We propose more systematic and professional biobanking training programs in accordance with ISO 20387, in addition to the certification programs of the National Biobank and the Korean Laboratory Accreditation System. We suggest various training programs appropriate to a student’s affiliation or work, such as university biobanking specialized education, short-term job training at unit biobanks, biobank research institute symposiums by the Korean Society of Pathologists, and education programs for biobankers and researchers. Through these various education programs, we expect that Korean biobanks will satisfy global standards, meet the needs of users and researchers, and contribute to the advancement of science.

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Development of a big data platform for collecting and utilizing clinical information from the Korea Biobank Network
Yun Seon Im, Seol Whan Oh, Ki Hoon Kim, Wona Choi, In Young Choi
BMC Medical Informatics and Decision Making.2025;[Epub] CrossRef
Frozen section histopathology and preanalytical factors affecting nucleic acid integrity in biobanked fresh-frozen human cancer tissues
Soungeun Kim, Jaewon Kang, Boyeon Kim, Yoonjin Kwak, Hye Seung Lee
Journal of Pathology and Translational Medicine.2025; 59(6): 398. CrossRef

A standardized pathology report for gastric cancer: 2nd edition: Young Soo Park, Myeong-Cherl Kook, Baek-hui Kim, Hye Seung Lee, Dong-Wook Kang, Mi-Jin Gu, Ok Ran Shin, Younghee Choi, Wonae Lee, Hyunki Kim, In Hye Song, Kyoung-Mee Kim, Hee Sung Kim, Guhyun Kang, Do Youn Park, So-Young Jin, Joon Mee Kim, Yoon Jung Choi, Hee Kyung Chang, Soomin Ahn, Mee Soo Chang, Song-Hee Han, Yoonjin Kwak, An Na Seo, Sung Hak Lee, Mee-Yon Cho; J Pathol Transl Med. 2023;57(1):1-27. Published online January 15, 2023; DOI: https://doi.org/10.4132/jptm.2022.12.23

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Abstract PDF Supplementary Material

The first edition of ‘A Standardized Pathology Report for Gastric Cancer’ was initiated by the Gastrointestinal Pathology Study Group of the Korean Society of Pathologists and published 17 years ago. Since then, significant advances have been made in the pathologic diagnosis, molecular genetics, and management of gastric cancer (GC). To reflect those changes, a committee for publishing a second edition of the report was formed within the Gastrointestinal Pathology Study Group of the Korean Society of Pathologists. This second edition consists of two parts: standard data elements and conditional data elements. The standard data elements contain the basic pathologic findings and items necessary to predict the prognosis of GC patients, and they are adequate for routine surgical pathology service. Other diagnostic and prognostic factors relevant to adjuvant therapy, including molecular biomarkers, are classified as conditional data elements to allow each pathologist to selectively choose items appropriate to the environment in their institution. We trust that the standardized pathology report will be helpful for GC diagnosis and facilitate large-scale multidisciplinary collaborative studies.

Citations

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Spatial and Temporal Tumor Heterogeneity in Gastric Cancer: Discordance of Predictive Biomarkers
Hye Seung Lee
Journal of Gastric Cancer.2025; 25(1): 192. CrossRef
PD-L1 as a Biomarker in Gastric Cancer Immunotherapy
Yunjoo Cho, Soomin Ahn, Kyoung-Mee Kim
Journal of Gastric Cancer.2025; 25(1): 177. CrossRef
Korean Gastric Cancer Association-Led Nationwide Survey on Surgically Treated Gastric Cancers in 2023
Dong Jin Kim, Jeong Ho Song, Ji-Hyeon Park, Sojung Kim, Sin Hye Park, Cheol Min Shin, Yoonjin Kwak, Kyunghye Bang, Chung-sik Gong, Sung Eun Oh, Yoo Min Kim, Young Suk Park, Jeesun Kim, Ji Eun Jung, Mi Ran Jung, Bang Wool Eom, Ki Bum Park, Jae Hun Chung, S
Journal of Gastric Cancer.2025; 25(1): 115. CrossRef
A Comprehensive and Comparative Review of Global Gastric Cancer Treatment Guidelines: 2024 Update
Sang Soo Eom, Keun Won Ryu, Hye Sook Han, Seong-Ho Kong
Journal of Gastric Cancer.2025; 25(1): 153. CrossRef
Korea, Japan, Europe, and the United States: Why are guidelines for gastric cancer different?
Emily E. Stroobant, Seong-Ho Kong, Maria Bencivenga, Takahiro Kinoshita, Tae-Han Kim, Takeshi Sano, Giovanni de Manzoni, Han-Kwang Yang, Yuko Kitagawa, Vivian E. Strong
Gastric Cancer.2025; 28(4): 559. CrossRef
Can the Japanese guidelines for endoscopic submucosal dissection be safely applied to Korean gastric cancer patients? A multicenter retrospective study based on the Korean Gastric Cancer Association nationwide survey
Hayemin Lee, Mi Ryeong Park, Junhyun Lee
Annals of Surgical Treatment and Research.2025; 109(2): 81. CrossRef
Double optimal transport for differential gene regulatory network inference with unpaired samples
Mengyu Li, Bencong Zhu, Cheng Meng, Xiaodan Fan, Laura Cantini
Bioinformatics.2025;[Epub] CrossRef
A Randomized Controlled Trial to Evaluate the Effect of Fibrin Glue on Bleeding after Gastric Endoscopic Submucosal Dissection
Tae-Se Kim, Tae-Jun Kim, Yang Won Min, Hyuk Lee, Byung-Hoon Min, Jun Haeng Lee, Poong-Lyul Rhee, Jae J. Kim
Gut and Liver.2025; 19(5): 677. CrossRef
Diagnostic accuracy of stereomicroscopy assessment of invasion depth in ex vivo specimens of early gastric cancer
Jing Wang, Lin Chang, Dong-Feng Niu, Yan Yan, Chang-Qi Cao, Shi-Jie Li, Qi Wu
World Journal of Gastroenterology.2025;[Epub] CrossRef
SMMILe enables accurate spatial quantification in digital pathology using multiple-instance learning
Zeyu Gao, Anyu Mao, Yuxing Dong, Hannah Clayton, Jialun Wu, Jiashuai Liu, ChunBao Wang, Kai He, Tieliang Gong, Chen Li, Mireia Crispin-Ortuzar
Nature Cancer.2025; 6(12): 2025. CrossRef
Genomic and Transcriptomic Characterization of Gastric Cancer with Bone Metastasis
Sujin Oh, Soo Kyung Nam, Keun-Wook Lee, Hye Seung Lee, Yujun Park, Yoonjin Kwak, Kyu Sang Lee, Ji-Won Kim, Jin Won Kim, Minsu Kang, Young Suk Park, Sang-Hoon Ahn, Yun-Suhk Suh, Do Joong Park, Hyung Ho Kim
Cancer Research and Treatment.2024; 56(1): 219. CrossRef
Microscopic tumor mapping of post-neoadjuvant therapy pancreatic cancer specimens to predict post-surgical recurrence: A prospective cohort study
Yeshong Park, Yeon Bi Han, Jinju Kim, MeeYoung Kang, Boram Lee, Eun Sung Ahn, Saemi Han, Haeryoung Kim, Hee-Young Na, Ho-Seong Han, Yoo-Seok Yoon
Pancreatology.2024; 24(4): 562. CrossRef
Effect of Neoadjuvant Chemotherapy on Tumor-Infiltrating Lymphocytes in Resectable Gastric Cancer: Analysis from a Western Academic Center
Elliott J. Yee, Danielle Gilbert, Jeffrey Kaplan, Sachin Wani, Sunnie S. Kim, Martin D. McCarter, Camille L. Stewart
Cancers.2024; 16(7): 1428. CrossRef
Interpretation of PD-L1 expression in gastric cancer: summary of a consensus meeting of Korean gastrointestinal pathologists
Soomin Ahn, Yoonjin Kwak, Gui Young Kwon, Kyoung-Mee Kim, Moonsik Kim, Hyunki Kim, Young Soo Park, Hyeon Jeong Oh, Kyoungyul Lee, Sung Hak Lee, Hye Seung Lee
Journal of Pathology and Translational Medicine.2024; 58(3): 103. CrossRef
Expression of claudin 18.2 in poorly cohesive carcinoma and its association with clinicopathologic parameters in East Asian patients
Moonsik Kim, Byung Woog Kang, Jihyun Park, Jin Ho Baek, Jong Gwang Kim
Pathology - Research and Practice.2024; 263: 155628. CrossRef
Clinicopathological analysis of claudin 18.2 focusing on intratumoral heterogeneity and survival in patients with metastatic or unresectable gastric cancer
T.-Y. Kim, Y. Kwak, S.K. Nam, D. Han, D.-Y. Oh, S.-A. Im, H.S. Lee
ESMO Open.2024; 9(12): 104000. CrossRef
Pathological Interpretation of Gastric Tumors in Endoscopic Submucosal Dissection
Jung Yeon Kim
Journal of Digestive Cancer Research.2023; 11(1): 15. CrossRef
Histopathology of Gastric Cancer
Baek-hui Kim, Sung Hak Lee
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2023; 23(2): 143. CrossRef
Endoscopic submucosal dissection hands-on training with artificial mucosal layer EndoGEL
Tae-Se Kim, Jun Haeng Lee
Journal of Innovative Medical Technology.2023; 1(1): 5. CrossRef

Standardization of the pathologic diagnosis of appendiceal mucinous neoplasms: Dong-Wook Kang, Baek-hui Kim, Joon Mee Kim, Jihun Kim, Hee Jin Chang, Mee Soo Chang, Jin-Hee Sohn, Mee-Yon Cho, So-Young Jin, Hee Kyung Chang, Hye Seung Han, Jung Yeon Kim, Hee Sung Kim, Do Youn Park, Ha Young Park, So Jeong Lee, Wonae Lee, Hye Seung Lee, Yoo Na Kang, Younghee Choi; J Pathol Transl Med. 2021;55(4):247-264. Published online July 8, 2021; DOI: https://doi.org/10.4132/jptm.2021.05.28

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Abstract PDF Supplementary Material

Although the understanding of appendiceal mucinous neoplasms (AMNs) and their relationship with disseminated peritoneal mucinous disease have advanced, the diagnosis, classification, and treatment of AMNs are still confusing for pathologists and clinicians. The Gastrointestinal Pathology Study Group of the Korean Society of Pathologists (GPSG-KSP) proposed a multicenter study and held a workshop for the “Standardization of the Pathologic Diagnosis of the Appendiceal Mucinous Neoplasm” to overcome the controversy and potential conflicts. The present article is focused on the diagnostic criteria, terminologies, tumor grading, pathologic staging, biologic behavior, treatment, and prognosis of AMNs and disseminated peritoneal mucinous disease. In addition, GPSG-KSP proposes a checklist of standard data elements of appendiceal epithelial neoplasms to standardize pathologic diagnosis. We hope the present article will provide pathologists with updated knowledge on how to handle and diagnose AMNs and disseminated peritoneal mucinous disease.

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Intrasplenic metastasis of appendiceal low-grade mucinous neoplasm – A case report and review of the literature
P. Meister, J. Rawitzer, M. Reschke, H.A. Baba, U. Neumann, M. Kaths
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Javier Miguez González, Francesc Calaf Forn, Laura Pelegrí Martínez, Pilar Lozano Arranz, Rafael Oliveira Caiafa, Jordi Català Forteza, Lina Maria Palacio Arteaga, Ferrán Losa Gaspà, Isabel Ramos Bernadó, Pedro Barrios Sánchez, Juan Ramón Ayuso Colella
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Marian Constantin, Cristina Mătanie, Livia Petrescu, Alexandra Bolocan, Octavian Andronic, Coralia Bleotu, Mihaela Magdalena Mitache, Sorin Tudorache, Corneliu Ovidiu Vrancianu
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Original Article

A scoring system for the diagnosis of non-alcoholic steatohepatitis from liver biopsy: Kyoungbun Lee, Eun Sun Jung, Eunsil Yu, Yun Kyung Kang, Mee-Yon Cho, Joon Mee Kim, Woo Sung Moon, Jin Sook Jeong, Cheol Keun Park, Jae-Bok Park, Dae Young Kang, Jin Hee Sohn, So-Young Jin; J Pathol Transl Med. 2020;54(3):228-236. Published online April 15, 2020; DOI: https://doi.org/10.4132/jptm.2020.03.07

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Abstract PDF

Background
Liver biopsy is the essential method to diagnose non-alcoholic steatohepatitis (NASH), but histological features of NASH are too subjective to achieve reproducible diagnoses in early stages of disease. We aimed to identify the key histological features of NASH and devise a scoring model for diagnosis.
Methods
Thirteen pathologists blindly assessed 12 histological factors and final histological diagnoses (‘not-NASH,’ ‘borderline,’ and ‘NASH’) of 31 liver biopsies that were diagnosed as non-alcoholic fatty liver disease (NAFLD) or NASH before and after consensus. The main histological parameters to diagnose NASH were selected based on histological diagnoses and the diagnostic accuracy and agreement of 12 scoring models were compared for final diagnosis and the NAFLD Activity Score (NAS) system.
Results
Inter-observer agreement of final diagnosis was fair (κ = 0.25) before consensus and slightly improved after consensus (κ = 0.33). Steatosis at more than 5% was the essential parameter for diagnosis. Major diagnostic factors for diagnosis were fibrosis except 1C grade and presence of ballooned cells. Minor diagnostic factors were lobular inflammation ( ≥ 2 foci/ × 200 field), microgranuloma, and glycogenated nuclei. All 12 models showed higher inter-observer agreement rates than NAS and post-consensus diagnosis (κ = 0.52–0.69 vs. 0.33). Considering the reproducibility of factors and practicability of the model, summation of the scores of major (× 2) and minor factors may be used for the practical diagnosis of NASH.
Conclusions
A scoring system for the diagnosis of NAFLD would be helpful as guidelines for pathologists and clinicians by improving the reproducibility of histological diagnosis of NAFLD.

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Preclinical liver toxicity models: Advantages, limitations and recommendations
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Reviews

Standardized Pathology Report for Colorectal Cancer, 2nd Edition: Baek-hui Kim, Joon Mee Kim, Gyeong Hoon Kang, Hee Jin Chang, Dong Wook Kang, Jung Ho Kim, Jeong Mo Bae, An Na Seo, Ho Sung Park, Yun Kyung Kang, Kyung-Hwa Lee, Mee Yon Cho, In-Gu Do, Hye Seung Lee, Hee Kyung Chang, Do Youn Park, Hyo Jeong Kang, Jin Hee Sohn, Mee Soo Chang, Eun Sun Jung, So-Young Jin, Eunsil Yu, Hye Seung Han, Youn Wha Kim; J Pathol Transl Med. 2020;54(1):1-19. Published online November 13, 2019; DOI: https://doi.org/10.4132/jptm.2019.09.28

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Abstract PDF Supplementary Material

The first edition of the ‘Standardized Pathology Report for Colorectal Cancer,’ which was developed by the Gastrointestinal Pathology Study Group (GIP) of the Korean Society of Pathologists, was published 13 years ago. Meanwhile, there have been many changes in the pathologic diagnosis of colorectal cancer (CRC), pathologic findings included in the pathology report, and immunohistochemical and molecular pathology required for the diagnosis and treatment of colorectal cancer. In order to reflect these changes, we (GIP) decided to make the second edition of the report. The purpose of this standardized pathology report is to provide a practical protocol for Korean pathologists, which could help diagnose and treat CRC patients. This report consists of “standard data elements” and “conditional data elements.” Basic pathologic findings and parts necessary for prognostication of CRC patients are classified as “standard data elements,” while other prognostic factors and factors related to adjuvant therapy are classified as “conditional data elements” so that each institution could select the contents according to the characteristics of the institution. The Korean version is also provided separately so that Korean pathologists can easily understand and use this report. We hope that this report will be helpful in the daily practice of CRC diagnosis.

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Molecular Testing for Gastrointestinal Cancer: Hye Seung Lee, Woo Ho Kim, Yoonjin Kwak, Jiwon Koh, Jeong Mo Bae, Kyoung-Mee Kim, Mee Soo Chang, Hye Seung Han, Joon Mee Kim, Hwal Woong Kim, Hee Kyung Chang, Young Hee Choi, Ji Y. Park, Mi Jin Gu, Min Jin Lhee, Jung Yeon Kim, Hee Sung Kim, Mee-Yon Cho; J Pathol Transl Med. 2017;51(2):103-121. Published online February 19, 2017; DOI: https://doi.org/10.4132/jptm.2017.01.24

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Abstract PDF

With recent advances in molecular diagnostic methods and targeted cancer therapies, several molecular tests have been recommended for gastric cancer (GC) and colorectal cancer (CRC). Microsatellite instability analysis of gastrointestinal cancers is performed to screen for Lynch syndrome, predict favorable prognosis, and screen patients for immunotherapy. The epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor has been approved in metastatic CRCs with wildtype RAS (KRAS and NRAS exon 2–4). A BRAF mutation is required for predicting poor prognosis. Additionally, amplification of human epidermal growth factor receptor 2 (HER2) and MET is also associated with resistance to EGFR inhibitor in metastatic CRC patients. The BRAF V600E mutation is found in sporadic microsatellite unstable CRCs, and thus is helpful for ruling out Lynch syndrome. In addition, the KRAS mutation is a prognostic biomarker and the PIK3CA mutation is a molecular biomarker predicting response to phosphoinositide 3-kinase/AKT/mammalian target of rapamycin inhibitors and response to aspirin therapy in CRC patients. Additionally, HER2 testing should be performed in all recurrent or metastatic GCs. If the results of HER2 immunohistochemistry are equivocal, HER2 silver or fluorescence in situ hybridization testing are essential for confirmative determination of HER2 status. Epstein-Barr virus–positive GCs have distinct characteristics, including heavy lymphoid stroma, hypermethylation phenotype, and high expression of immune modulators. Recent advances in next-generation sequencing technologies enable us to examine various genetic alterations using a single test. Pathologists play a crucial role in ensuring reliable molecular testing and they should also take an integral role between molecular laboratories and clinicians.

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Original Articles

Interobserver Agreement on Pathologic Features of Liver Biopsy Tissue in Patients with Nonalcoholic Fatty Liver Disease: Eun Sun Jung, Kyoungbun Lee, Eunsil Yu, Yun Kyung Kang, Mee-Yon Cho, Joon Mee Kim, Woo Sung Moon, Jin Sook Jeong, Cheol Keun Park, Jae-Bok Park, Dae Young Kang, Jin Hee Sohn, So-Young Jin; J Pathol Transl Med. 2016;50(3):190-196. Published online April 18, 2016; DOI: https://doi.org/10.4132/jptm.2016.03.01

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272 Download
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Abstract PDF

Background
The histomorphologic criteria for the pathological features of liver tissue from patients with non-alcoholic fatty liver disease (NAFLD) remain subjective, causing confusion among pathologists and clinicians. In this report, we studied interobserver agreement of NAFLD pathologic features and analyzed causes of disagreement.
Methods
Thirty-one cases of clinicopathologically diagnosed NAFLD from 10 hospitals were selected. One hematoxylin and eosin and one Masson’s trichrome-stained virtual slide from each case were blindly reviewed with regard to 12 histological parameters by 13 pathologists in a gastrointestinal study group of the Korean Society of Pathologists. After the first review, we analyzed the causes of disagreement and defined detailed morphological criteria. The glass slides from each case were reviewed a second time after a consensus meeting. The degree of interobserver agreement was determined by multi-rater kappa statistics.
Results
Kappa values of the first review ranged from 0.0091–0.7618. Acidophilic bodies (k = 0.7618) and portal inflammation (k = 0.5914) showed high levels of agreement, whereas microgranuloma (k = 0.0984) and microvesicular fatty change (k = 0.0091) showed low levels of agreement. After the second review, the kappa values of the four major pathological features increased from 0.3830 to 0.5638 for steatosis grade, from 0.1398 to 0.2815 for lobular inflammation, from 0.1923 to 0.3362 for ballooning degeneration, and from 0.3303 to 0.4664 for fibrosis.
Conclusions
More detailed histomorphological criteria must be defined for correct diagnosis and high interobserver agreement of NAFLD.

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Prognostic Implication of Semi-quantitative Immunohistochemical Assessment of CD20 Expression in Diffuse Large B-Cell Lymphoma: Chang Hwan Choi, Young Hoon Park, Joo Han Lim, Suk Jin Choi, Lucia Kim, In Suh Park, Jee Young Han, Joon Mee Kim, Young Chae Chu; J Pathol Transl Med. 2016;50(2):96-103. Published online February 15, 2016; DOI: https://doi.org/10.4132/jptm.2016.01.12

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Background
Immunohistochemical demonstration of CD20 in diffuse large B-cell lymphoma (DLBCL) is prerequisite not only for the diagnosis but also for assigning patients to rituximab-containing chemotherapy. However, little is known about the impact of abundance of CD20 expression assessed by immunohistochemistry on the clinical outcome of DLBCL. We performed a semi-quantitative immunohistochemical analysis of CD20 expression in DLBCL to examine the prognostic implication of the level of CD20 expression. Methods: Pre-treatment diagnostic tissue samples from 48 DLBCL patients who were treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) regimen were represented in a tissue microarray and immunostained for CD20. The relative abundance of CD20 expression was semi-quantitatively scored using a web-based ImmunoMembrane plug-in. Receiver operating characteristic curve analysis was used to determine a prognostically relevant cut-off score in order to dichotomize the patients into CD20-high versus CD20-low groups. Results: The levels of CD20 expression were heterogeneous among the patients, with a wide and linear distribution of scores. Patients in CD20-low group showed significantly poor clinical outcome. Conclusions: The levels of CD20 expression in DLBCL are heterogeneous among the patients with DLBCL. A subgroup of the patients with CD20 expression levels below the cut-off score showed poor clinical outcome.

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Brief Case Report

Myoepithelial Carcinoma of Soft Tissue: A Case Report and Review of the Literature: Chang Hwan Choi, Young Chae Chu, Lucia Kim, Suk Jin Choi, In Suh Park, Jee Young Han, Joon Mee Kim; Korean J Pathol. 2014;48(6):413-417. Published online December 31, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.6.413

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Original Articles

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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Abstract PDF

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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The Clinicopathological Significance of Epithelial Mesenchymal Transition Associated Protein Expression in Head and Neck Squamous Cell Carcinoma: Kyu Ho Kim, Lucia Kim, Suk Jin Choi, Jee Young Han, Joon Mee Kim, Young Chae Chu, Young-Mo Kim, In Suh Park, Joo Han Lim; Korean J Pathol. 2014;48(4):263-269. Published online August 26, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.4.263

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Abstract PDF

Background

Epithelial mesenchymal transition (EMT) has an important role in invasion and metastasis of tumor cells. The purpose of this study was to evaluate the roles of EMT-associated proteins on progression and metastasis as a prognostic/predictive factor in curatively-resected (R0) head and neck squamous cell carcinoma (HNSCC).

Methods

A total of 118 patients who received curative surgery for HNSCC at Inha University Hospital between January 1996 and December 2011 were included. We used protein immunohistochemistry to evaluate the expression of E-cadherin, vimentin, and EZH2 on tissue microarrays. Also, we reviewed all medical records and analyzed the relationship between the expression of EMT-associated proteins and prognosis.

Results

The E-cadherin-negative group showed more moderate/poor differentiation of cancer cell type than the higher E-cadherin-expressing group (p=.016) and high EZH2 expression was significantly correlated with nodal metastasis (p=.012). Our results demonstrate a significant association between high expression of EZH2 and vimentin and presence of distant progression (p=.026). However, expression of E-cadherin, vimentin, and EZH2 was not significantly associated with overall survival.

Conclusions

These findings suggest that an EMT-associated protein expression profile is correlated with aggressiveness of disease and prognosis, and could be a useful marker for determination of additional treatment in curatively-resected HNSCC patients.

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EZH2 overexpression in head and neck cancer is related to lymph node metastasis
Julie C. Nienstedt, Cornelia Schroeder, Till Clauditz, Ronald Simon, Guido Sauter, Adrian Muenscher, Marco Blessmann, Henning Hanken, Christina Pflug
Journal of Oral Pathology & Medicine.2018; 47(3): 240. CrossRef
MiR-876-5p modulates head and neck squamous cell carcinoma metastasis and invasion by targeting vimentin
Yibo Dong, Yang Zheng, Chundi Wang, Xu Ding, Yifei Du, Laikui Liu, Wei Zhang, Wei Zhang, Yi Zhong, Yunong Wu, Xiaomeng Song
Cancer Cell International.2018;[Epub] CrossRef
HMGA2 is associated with the aggressiveness of tongue squamous cell carcinoma
H Zhang, Z Tang, C Deng, Y He, F Wu, O Liu, C Hu
Oral Diseases.2017; 23(2): 255. CrossRef
miR-375 Regulates Invasion-Related Proteins Vimentin and L-Plastin
Lizandra Jimenez, Jihyeon Lim, Berta Burd, Thomas M. Harris, Thomas J. Ow, Nicole Kawachi, Thomas J. Belbin, Ruth Angeletti, Michael B. Prystowsky, Geoffrey Childs, Jeffrey E. Segall
The American Journal of Pathology.2017; 187(7): 1523. CrossRef
Functional and therapeutic significance of EZH2 in urological cancers
Xiaobing Liu, Qingjian Wu, Longkun Li
Oncotarget.2017; 8(23): 38044. CrossRef
EZH2, an on–off valve in signal network of tumor cells
Shanshan Sun, Feng Yu, Lun Zhang, Xuan Zhou
Cellular Signalling.2016; 28(5): 481. CrossRef
High EZH2 Protein Expression Is Associated with Poor Overall Survival in Patients with Luminal A Breast Cancer
Si-Hyong Jang, Jong Eun Lee, Mee-Hye Oh, Ji-Hye Lee, Hyun Deuk Cho, Kyung-Ju Kim, Sung Yong Kim, Sun Wook Han, Han Jo Kim, Sang Byung Bae, Hyun Ju Lee
Journal of Breast Cancer.2016; 19(1): 53. CrossRef
EZH2 promotes invasion and metastasis of laryngeal squamous cells carcinoma via epithelial-mesenchymal transition through H3K27me3
HuaNan Luo, Yuan Jiang, SiJing Ma, HuanHuan Chang, ChunXi Yi, Hui Cao, Ying Gao, HaiLi Guo, Jin Hou, Jing Yan, Ying Sheng, XiaoYong Ren
Biochemical and Biophysical Research Communications.2016; 479(2): 253. CrossRef

Early Colorectal Epithelial Neoplasm in Korea: A Multicenter Survey of Pathologic Diagnosis: Yun Kyung Kang, So-Young Jin, Mee Soo Chang, Jung Yeon Kim, Gyeong Hoon Kang, Hye Seung Lee, Jin Hee Sohn, Ho Sung Park, Kye Won Kwon, Mi Jin Gu, Young Hee Maeng, Jong Eun Joo, Haeng Ji Kang, Hee Kyung Kim, Kee-Taek Jang, Mi Ja Lee, Hee Kyung Chang, Joon Mee Kim, Hye Seung Han, Won Ae Lee, Yoon Jung Choi, Dong Wook Kang, Sunhoo Park, Jae Hyuk Lee, Mee-Yon Cho; Korean J Pathol. 2013;47(3):245-251. Published online June 25, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.3.245

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Abstract PDF

Background

The incidence of early colorectal epithelial neoplasm (ECEN) is increasing, and its pathologic diagnosis is important for patient care. We investigated the incidence of ECEN and the current status of its pathologic diagnosis.

Methods

We collected datasheets from 25 institutes in Korea for the incidence of colorectal adenoma with high grade dysplasia (HGD) and low grade dysplasia in years 2005, 2007, and 2009; and early colorectal carcinoma in the year 2009. We also surveyed the diagnostic terminology of ECEN currently used by the participating pathologists.

Results

The average percentage of diagnoses of adenoma HGD was 7.0%, 5.0%, and 3.4% in years 2005, 2007, and 2009, respectively. The range of incidence rates of adenoma HGD across the participating institutes has gradually narrowed over the years 2005 to 2009. The incidence rate of early colorectal carcinoma in the year 2009 was 21.2%. The participants did not share a single criterion or terminology for the diagnosis of adenoma HGD. The majority accepted the diagnostic terms that distinguished noninvasive, mucosal confined, and submucosal invasive carcinoma.

Conclusions

Further research requirements suggested are a diagnostic consensus for the histopathologic diagnosis of ECEN; and standardization of diagnostic terminology critical for determining the disease code.

Citations

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Diminutive and Small Colorectal Polyps: The Pathologist's Perspective
Yun Kyung Kang
Clinical Endoscopy.2014; 47(5): 404. CrossRef

In-house Manual Construction of High-Density and High-Quality Tissue Microarrays by Using Homemade Recipient Agarose-Paraffin Blocks: Kyu Ho Kim, Suk Jin Choi, Yeon Il Choi, Lucia Kim, In Suh Park, Jee Young Han, Joon Mee Kim, Young Chae Chu; Korean J Pathol. 2013;47(3):238-244. Published online June 25, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.3.238

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Abstract PDF

Background

Self-made tissue punches can be effectively used to punch holes in blank recipient paraffin blocks and extract tissue cores from the donor paraffin blocks for the low-cost construction of tissue microarrays (TMAs). However, variable degrees of section distortion and loss of the tissue cores can occurs during cutting of the TMAs, posing technical problems for in-house manual construction of high-density TMAs. We aimed to update the method for in-house manual TMA construction to improve the quality of high-density TMAs.

Methods

Blocks of agarose gel were subjected to the standard tissue processing and embedding procedure to prepare recipient agarose-paraffin blocks. The self-made tissue punches and recipient agarose-paraffin blocks were used to construct TMAs, which were completely melted and re-embedded in paraffin to make finished TMA blocks.

Results

The donor tissue cores were completely integrated into the surrounding paraffin of the recipient blocks. This method enabled us to construct high-density TMAs with significantly less section distortion or loss of tissue cores during microtomy.

Conclusions

Simple and inexpensive construction of high-density and high-quality TMAs can be warranted by using paraffinized agarose gels as recipient blocks.

Citations

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Using Quality Function Deployment to Design an Image-Guided, Multibiopsy Tool for Neurosurgical Applications
Kaytlin Andrews, Hunter Dejean, Cameron MacLeod, Kate Prieditis, Heidi-Lynn Ploeg, James Purzner, Teresa Purzner
Operative Neurosurgery.2025;[Epub] CrossRef
An introduction of an easy-operating and economical technique for tissue microarray preparation
Yi-Jing Chen, Chun-Mei Yang, Jiang-Sheng Huang, Ping Wang, Yan-Hua Lv, Cheng Tang, Wei Deng
Journal of Clinical Pathology.2020; 73(7): 403. CrossRef
Optimization of Tissue Microarrays from Banked Human Formalin-Fixed Paraffin Embedded Tissues in the Cancer Research Setting
Tammy Sexton, Gregory L. Kucera, Edward A. Levine, Kounosuke Watabe, Stacey S. O'Neill
Biopreservation and Biobanking.2019; 17(5): 452. CrossRef
Monocarboxylate transporters MCT1 and MCT4 are independent prognostic biomarkers for the survival of patients with clear cell renal cell carcinoma and those receiving therapy targeting angiogenesis
Yan-Wei Cao, Yong Liu, Zhen Dong, Lei Guo, En-Hao Kang, Yong-Hua Wang, Wei Zhang, Hai-Tao Niu
Urologic Oncology: Seminars and Original Investigations.2018; 36(6): 311.e15. CrossRef
Platelet-derived growth factor receptor α in hepatocellular carcinoma is a prognostic marker independent of underlying liver cirrhosis
Jung-Hwan Yu, Joon Mee Kim, Ja Kyung Kim, Suk Jin Choi, Kwan Sik Lee, Jin-Woo Lee, Hye Young Chang, Jung Il Lee
Oncotarget.2017; 8(24): 39534. CrossRef
Prognostic Implication of Semi-quantitative Immunohistochemical Assessment of CD20 Expression in Diffuse Large B-Cell Lymphoma
Chang Hwan Choi, Young Hoon Park, Joo Han Lim, Suk Jin Choi, Lucia Kim, In Suh Park, Jee Young Han, Joon Mee Kim, Young Chae Chu
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High Quality Tissue Miniarray Technique Using a Conventional TV/Radio Telescopic Antenna
Mohamed A. Elkablawy, Abdulkader M. Albasri
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Proposal for a Standardized Pathology Report of Gastroenteropancreatic Neuroendocrine Tumors: Prognostic Significance of Pathological Parameters: Mee-Yon Cho, Jin Hee Sohn, So Young Jin, Hyunki Kim, Eun Sun Jung, Mi-Jung Kim, Kyoung-Mee Kim, Woo Ho Kim, Joon Mee Kim, Yun Kyung Kang, Joon Hyuk Choi, Dae Young Kang, Youn Wha Kim, Eun Hee Choi; Korean J Pathol. 2013;47(3):227-237. Published online June 25, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.3.227

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Abstract PDF

Background

There is confusion in the diagnosis and biological behaviors of gastroenteropancreatic neuroendocrine tumors (GEP-NETs), because of independently proposed nomenclatures and classifications. A standardized form of pathology report is required for the proper management of patients.

Methods

We discussed the proper pathological evaluation of GEP-NET at the consensus conference of the subcommittee meeting for the Gastrointestinal Pathology Study Group of the Korean Society of Pathologists. We then verified the prognostic significance of pathological parameters from our previous nationwide collection of pathological data from 28 hospitals in Korea to determine the essential data set for a pathology report.

Results

Histological classification, grading (mitosis and/or Ki-67 labeling index), T staging (extent, size), lymph node metastasis, and lymphovascular and perineural invasion were significant prognostic factors and essential for the pathology report of GEP-NET, while immunostaining such as synaptophysin and chromogranin may be optional. Furthermore, the staging system, either that of the 2010 American Joint Cancer Committee (AJCC) or the European Neuroendocrine Tumor Society (ENETS), should be specified, especially for pancreatic neuroendocrine neoplasms.

Conclusions

A standardized pathology report is crucial for the proper management and prediction of prognosis of patients with GEP-NET.

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Case Study

Peripheral Primitive Neuroectodermal Tumor with Osseous Component of the Small Bowel Mesentery: A Case Study: Joon Mee Kim, Young Chae Chu, Chang Hwan Choi, Lucia Kim, Suk Jin Choi, In Suh Park, Jee Young Han, Kyung Rae Kim, Yoon-La Choi, Taeeun Kim; Korean J Pathol. 2013;47(1):77-81. Published online February 25, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.1.77

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Abstract PDF

A case of peripheral primitive neuroectodermal tumor of the small bowel mesentery with osseous component is reported. A 23-year-old man was admitted to our hospital because of acute severe abdominal pain. Abdominal computed tomography revealed a large solid and cystic, oval shaped mass, measuring 11.0×6.0 cm in the pelvic cavity. Histologically the resected lesion consisted of sheets of undifferentiated small round cells forming Homer-Wright rosettes and perivascular pseudorosettes, and showed areas of osteoid and bone formation. Immunohistochemical studies revealed that tumor cells expressed positivity against CD99 (MIC2), CD57, neuron-specific enolase, and vimentin. Fluorescence in situ hybridization study revealed Ewing sarcoma breakpoint region 1 (EWSR1) gene rearrangement on chromosome 22q12. To the authors' knowledge this is the first documentation of a peripheral neuroectodermal tumor with osteoid and bone formation of the small bowel mesentery.

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Original Articles

Construction of High-Density Tissue Microarrays at Low Cost by Using Self-Made Manual Microarray Kits and Recipient Paraffin Blocks: Chang Hwan Choi, Kyu Ho Kim, Ju Young Song, Suk Jin Choi, Lucia Kim, In Suh Park, Jee Young Han, Joon Mee Kim, Young Chae Chu; Korean J Pathol. 2012;46(6):562-568. Published online December 26, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.6.562

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Abstract PDF

Background

Advances of tissue microarray (TMA) technology have enabled simultaneous in situ analysis of biomarker expression in a large number of archived pathology specimens. However, the relatively high cost of TMA construction may hamper many researchers from using this essential tool of modern pathology research. We discuss methods for making TMA kits and recipient blocks for manual construction of high-density TMAs at low cost.

Methods

Ordinary cannula piercing needles, hypodermic needles, bone marrow biopsy needles, metallic ink cartridges of ballpoint pens, and disposable skin biopsy punches were used to construct self-made manual TMA kits. The recipient blocks were manufactured by boring holes in the conventional bare paraffin blocks. A mini electric hand drill and a microcompound table assembled on a drill stand were used to maximize the capacity of the recipient blocks.

Results

By using TMA kits made from cannula piercing needles (16- and 18-gauge), it was possible to construct TMAs with 1 mm×140 cores, 0.6 mm×320 cores, 2 mm×70 cores, 3 mm×35 cores, and 5 mm×12 cores. The capacity of the recipient blocks could be dramatically increased by drilling holes.

Conclusions

Construction of TMAs using self-made TMA kits is an inexpensive alternative to construction of TMAs using commercial devices.

Citations

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Diagnostic Potential of CD44, CD133, and VDR in Epithelial Ovarian Tumors: Association with Histopathology Parameters
Ljubiša Jovanović, Branka Šošić-Jurjević, Anđa Ćirković, Sandra Dragičević, Branko Filipović, Svetlana Milenković, Stefan Dugalić, Miroslava Gojnić-Dugalić, Aleksandra Nikolić
International Journal of Molecular Sciences.2025; 26(8): 3729. CrossRef
Comparison of programmed death-1 (PD-1)-positive T-cells with known prognostic indicators in breast cancer
Ankit Kaushik, Anamika Jaiswal, B Priya, Ashish Jain, Sonal Sharma
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Constructing high-density tissue microarrays with a novel method and a self-made tissue-arraying instrument
Ping Qin, Liu Li, Li Zhao, Piaopiao Bian, Zhongtang Xiong
Pathology - Research and Practice.2023; 245: 154430. CrossRef
The correlation of PD-L1 expression in cytological and histological material of serous high-grade ovarian cancer
Ljubiša Jovanović, Anđa Ćirković, Ljubinka Nikolić, Milena Jović, Darko Mikić, Svetlana Milenković, Radmila Janković
Srpski medicinski casopis Lekarske komore.2023; 4(3): 246. CrossRef
Expression of estrogen and progesterone receptors, HER2 protein and Ki-67 proliferation index in breast carcinoma in both tumor tissue and tissue microarray
UP Hacısalihoğlu, MA Dogan
Biotechnic & Histochemistry.2022; 97(4): 298. CrossRef
PD-L1 Expression in High-Grade Serous and Clear Cell Ovarian Cancer
Ljubiša Jovanović, Andja Ćirković, Milena Jović, Radmila Janković
Indian Journal of Gynecologic Oncology.2022;[Epub] CrossRef
PD-L1 Expression in Different Segments and Histological Types of Ovarian Cancer According to Lymphocytic Infiltrate
Ljubiša Jovanović, Radmila Janković, Andja Ćirković, Milena Jović, Tijana Janjić, Slaviša Djuričić, Svetlana Milenković
Medicina.2021; 57(12): 1309. CrossRef
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Ulrich Vogel
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Hua Chang, Diane Peluso, Sadiq Hussain, Michail Shipitsin, Peter Blume-Jensen
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Kyu Ho Kim, Suk Jin Choi, Yeon Il Choi, Lucia Kim, In Suh Park, Jee Young Han, Joon Mee Kim, Young Chae Chu
Korean Journal of Pathology.2013; 47(3): 238. CrossRef

Update on the Proposal for Creating a Guideline for Cancer Registration of the Gastrointestinal Tumors (I-2): Eun Sun Jung, Yun Kyung Kang, Mee-Yon Cho, Joon Mee Kim, Won Ae Lee, Hee Eun Lee, Sunhoo Park, Jin Hee Sohn, So-Young Jin; Korean J Pathol. 2012;46(5):443-453. Published online October 25, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.5.443

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Abstract PDF

Background

Cancer registries play a fundamental role in cancer control and multicenter collaborative research. Recently, the need for reassessment of cancer registry criteria has arisen due to the newly released 2010 World Health Organization (WHO) classification. Accordingly, development of new coding guidelines for cancer is necessary to improve the quality of cancer registries, as well as to prevent conflicts that may arise when seeking medical insurance compensation.

Methods

With funding from the Management Center for Health Promotion, 35 members of the Gastrointestinal Pathology Study Group and the Cancer Registration Committee of the Korean Society of Pathologists (KSP) participated in a second workshop for gastrointestinal tumor registration in Korea.

Results

The topics of gastric epithelial tumor, colonic intramucosal carcinoma, neuroendocrine tumor (NET), gastrointestinal stromal tumor (GIST) and appendiceal mucinous tumor were discussed for new coding guidelines. A survey was then conducted among 208 members of the KSP for a consensus of the guidelines proposed in the workshop.

Conclusions

Although a few issues were set aside for further discussion, such as coding for non-gastric GIST and some types of NET, the members agreed upon most of the proposed guidelines. Therefore, we suggest using the newly revised International Classification of Diseases for Oncology, 3rd edition (ICD-O-3) coding guidelines for registering gastrointestinal tumors in Korea.

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Eun Young Kim, Il Ju Choi, Kwang An Kwon, Ji Kon Ryu, Seok Ho Dong, Ki Baik Hahm
Clinical Endoscopy.2014; 47(4): 285. CrossRef
Early Colorectal Epithelial Neoplasm in Korea: A Multicenter Survey of Pathologic Diagnosis
Yun Kyung Kang, So-Young Jin, Mee Soo Chang, Jung Yeon Kim, Gyeong Hoon Kang, Hye Seung Lee, Jin Hee Sohn, Ho Sung Park, Kye Won Kwon, Mi Jin Gu, Young Hee Maeng, Jong Eun Joo, Haeng Ji Kang, Hee Kyung Kim, Kee-Taek Jang, Mi Ja Lee, Hee Kyung Chang, Joon
Korean Journal of Pathology.2013; 47(3): 245. CrossRef
Expression of metallothionein‐1 and metallothionein‐2 as a prognostic marker in hepatocellular carcinoma
Yangsoon Park, Eunsil Yu
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DPC4 Expression in the Small Intestinal Adenocarcinomas: Sun Jae Lee, Eunsil Yu, Young Kyung Bae, Kee-Taek Jang, Joon Mee Kim, Han-Ik Bae, Seung-Mo Hong, Ghil Suk Yoon; Korean J Pathol. 2012;46(5):415-422. Published online October 25, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.5.415

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Abstract PDF

Background

Small intestinal adenocarcinomas (SACs) are rare malignancies of the alimentary tract with uncertain carcinogenesis.

Methods

We investigated the expression of deleted in pancreatic cancer 4 (DPC4) in 188 cases of surgically resected SACs, using tissue microarray technology.

Results

Twenty-four of the 188 tumors showed complete loss of Smad4/DPC4 expression in cytoplasm (score, 0; 12.8%). Eighty-four and 31 cases were moderately and strongly positive, respectively (score, 2 and 3; 44.7% and 16.5%, respectively) and 49 cases were focally or weakly stained (score, 1; 29.1%). Immunohistochemistry analysis showed that the expression of Smad4/DPC4 was related to an increased risk of lymphatic invasion but not to other clinicopathological features of the tumors (tumor location, differentiation, growth pattern, T stage, direct invasion, vascular invasion, and nodal metastasis). There was no significant association between Smad4/DPC4 expression and patient survival.

Conclusions

The present research is the first study to evaluate Smad4/DPC4 expression in a large sample of SACs with clinicopathologic correlation. Future studies should focus on the immunohistochemical and molecular characteristics of SACs to clarify their tumorigenesis.

Citations

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American Registry of Pathology Expert Opinions: Evaluation of poorly differentiated malignant neoplasms on limited samples - Gastrointestinal mucosal biopsies
Andrew M. Bellizzi, Elizabeth A. Montgomery, Jason L. Hornick
Annals of Diagnostic Pathology.2020; 44: 151419. CrossRef

Case Reports

Granular Cell Astrocytoma: Report of a Case: Kyu Ho Kim, Ju Young Song, Chang Hwan Choi, Lucia Kim, Suk Jin Choi, Jee Young Han, Joon Mee Kim, Young Chae Chu, In Suh Park; Korean J Pathol. 2012;46(4):370-372. Published online August 23, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.4.370

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Abstract PDF

We report here a rare case of granular cell astrocytoma. A 75-year-old man was admitted to Inha University Hospital with a three-month history of language deterioration. In a magnetic resonance imaging, a 6.5 cm-sized heterogeneous enhancing mass was seen in both the frontal lobes and the anterior genu of the corpus callosum. A stereotactic biopsy was performed. The tumor was composed of large and small round cells with abundant intracytoplasmic granules. The nuclei were bland, round to oval, and often eccentrically located. The cytoplasm of the tumor cells was positive for glial fibrillary acidic protein and S-100 protein.

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Hemlata Jangir, Charli Roy, Amandeep Kumar, Ajay Garg, Mehar Chand Sharma, Vaishali Suri
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Samuel López‐Muñoz, Borja Sánchez‐Cordon, Mario Taravilla‐Loma, Isabel Esteban‐Rodríguez
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Granular cell tumor of the brain: case report and review of literature
Shyam Duvuru, Vivek Sanker, Deepak Pandit, Sheezah Khan, Sara Alebrahim, Tirth Dave
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Granular cell astrocytoma: Case report
Rohan Gupta, Supriya Gupta, Nathaniel Shapiro, Scott Rahimi, Suash Sharma
Human Pathology: Case Reports.2018; 14: 4. CrossRef
Unusual presentation of a granular cell astrocytoma
Alan A George, Gregory N Fuller, Lauren A Langford, Clayton D Simon, Amy A Zingalis, Derek A Mathis
Histopathology.2013; 63(6): 883. CrossRef

Adenocarcinoma with Intraductal Papillary Mucinous Neoplasm Arising in Jejunal Heterotopic Pancreas: Ju Young Song, Jee Young Han, Sun Keun Choi, Lucia Kim, Suk Jin Choi, In Suh Park, Young Chae Chu, Kyu Ho Kim, Joon Mee Kim; Korean J Pathol. 2012;46(1):96-100. Published online February 23, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.1.96

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Abstract PDF

A 74-year-old man suffered from jejunal perforation and adhesion to sigmoid colon due to adenocarcinoma associated with intraductal papillary mucinous neoplasm (IPMN) arising in a jejunal heterotopic pancreas. The jejunal lesion showed direct extension to the sigmoid colon, which was mistaken as sigmoid colon cancer by surgeons. Malignant transformation is a rare complication of a heterotopic pancreas. About half of malignancies in reported cases were ductal adenocarcinoma arising in the stomach, and the jejunal location is extremely rare. Furthermore, IPMN is also uncommon finding in a heterotopic pancreas.

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Primary adenocarcinoma from a gastric heterotopic pancreas: A case report
Ya-Xin Wang, Jing Wang, Shi-Xiu Liang, Qi Wu
World Journal of Gastrointestinal Endoscopy.2025;[Epub] CrossRef
Pancreatic Intraductal Papillary Mucinous Neoplasm Arising Within Heterotopic Pancreas Tissue of the Stomach
Rinrada Worapongpaiboon, Kasenee Tiankanon, Benjamin L. Mazer, Saowanee Ngamruengphong
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Clinicopathological features of intraductal papillary mucinous neoplasm derived from ectopic pancreas: A systematic review
Jiro Kimura, Takehiro Okabayashi, Kenta Sui, Takahiro Murokawa, Motoyasu Tabuchi, Masaki Aida, Jun Iwata, Yasuhiro Hata
Surgery Open Science.2022; 8: 62. CrossRef
Clinicopathological Features of Intraductal Papillary Mucinous Neoplasm Derived from Ectopic Pancreas: A Systematic Review
Jiro Kimura, Takehiro Okabayashi, Kenta Sui, Takahiro Murokawa, Motoyasu Tabuchi, Masaki Aida, Jun Iwata, Yasuhiro Hata
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World Journal of Surgical Oncology.2021;[Epub] CrossRef
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Adenocarcinoma arising from jejunal ectopic pancreas mimicking peritoneal metastasis from colon cancer: a case report and literature review
Yusuke Yamaoka, Tomohiro Yamaguchi, Yusuke Kinugasa, Akio Shiomi, Hiroyasu Kagawa, Yushi Yamakawa, Masakatsu Numata, Shinya Sugimoto, Kenichiro Imai, Kinichi Hotta, Keiko Sasaki
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Fine Needle Aspiration Cytologic Findings of Angiosarcoma: Report of Two Cases.: Jin Xian Ji, Young Chae Chu, Lucia Kim, Suk Jin Choi, In Suh Park, Jee Young Han, Joon Mee Kim, Kyu Ho Kim, Ju Young Song; Korean J Pathol. 2011;45(2):217-222.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.2.217

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Abstract PDF

Angiosarcoma is a rare malignant vascular neoplasm which can arise in any part of the body. Specific recognition of this neoplasm in cytological specimens is difficult in the absence of an ancillary method. Herein, we present the cytologic findings of two cases of angiosarcomas diagnosed on fine needle aspiration cytology. One case is a recurred angiosarcoma in the left chest wall and the other case is a lymphedema-associated angiosarcoma in the left lower leg. The cytologic findings of both cases are similar. Cytologic features that identified this neoplasm as an angiosarcoma included arborizing microtissue fragments, irregular anastomosing vascular spaces lined by atypical cells, microacini, intracytoplasmic lumen, and intracellular red blood cells, marked cell discohesiveness, spindle to ovoid, irregular, hyperchromatic nuclei, and elongated cytoplasmic processes with indistinct borders. This report emphasizes that when aspiration smears show vasoformative features in a bloody background, angiosarcoma should be included in the differential diagnosis.

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A Case Series and Literature Review of Angiosarcoma With Malignant Effusion—A Challenging Cytologic Diagnosis With Dire Prognostic Implications
Jamie C. Y. Lam, Iris Y. H. Liu, Joanna K. M. Ng, Joshua J. X. Li
Diagnostic Cytopathology.2025;[Epub] CrossRef
Four newly reported ophichthid leptocephali species revealed by mitochondrial 12S rDNA, with implications of their occurrence in Korea
Hwan Sung Ji, Hae Won Lee, Byung Kyu Hong, Jin Koo Kim
Animal Cells and Systems.2012; 16(5): 415. CrossRef

Original Article

Cytologic Features of Prostatic Adenocarcinoma in Urine: Comparison with Urothelial Carcinoma.: Lucia Kim, Joo Young Song, Suk Jin Choi, In Suh Park, Jee Young Han, Joon Mee Kim, Young Chae Chu; Korean J Pathol. 2011;45(1):79-86.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.1.79

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Abstract PDF

BACKGROUND
Prostate adenocarcinoma (PACa) cells are rarely identified in urine cytology specimens and might be easily overlooked or misdiagnosed as urothelial neoplasm when clinically unsuspected.
METHODS
We reviewed 19 urine cytology specimens obtained from 13 patients with PACa and evaluated the characteristic features discriminating PACa from urothelial carcinoma (UCa). For comparison, 27 cases of high-grade UCa (HGUCa) and 10 cases of urothelial carcinoma in situ (UCis) were also evaluated.
RESULTS
The urine cytologic evaluation of PACa revealed clustered cells forming 3-dimensional syncytial fragments with occasional microacinar grouping in a clean background. Most tumor cells were small and uniform with a high nuclear-to-cytoplasmic ratio and indistinct cell borders. The nuclei were round-to-oval and the cytoplasm was scanty and thin. One or more centrally-located prominent nucleoli were characteristically noted in one half of the cases. The nucleoli had a well-defined, large, round and eosinophilic appearance. In four high-grade cases, large tumor cells were encountered and had relatively monotonous cells with smooth-outlined cell clusters, well-defined and thin cytoplasm, and round nuclei with characteristic prominent nucleoli.
CONCLUSIONS
Combining the information of prostate cancer and the recognition of cytomorphologic features of PACa will help differentiate PACa from HGUCa and UCis.

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Monique Courtade-Saïdi
Annales de Pathologie.2025; 45(2): 147. CrossRef
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Gabriel Pastrana, Camille L Santiago Negron, Suheidy Cardona, Juan C Santa Rosario, María D Rivera Rolón
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The diagnostic challenge of suspicious or positive malignant urine cytology findings when cystoscopy findings are normal: an outpatient blue-light flexible cystoscopy may solve the problem
Marie Andersson, Marthe Berger, Karsten Zieger, Per-Uno Malmström, Mats Bläckberg
Scandinavian Journal of Urology.2021; 55(4): 263. CrossRef
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Analytical Chemistry.2016; 88(19): 9564. CrossRef

Case Reports

Aspiration Cytology of Cervical Thymoma: A Case Report.: Xian Ji Jin, Ju Young Song, Suk Jin Choi, Lucia Kim, In Suh Park, Jee Young Han, Joon Mee Kim, Young Chae Chu; Korean J Pathol. 2010;44(4):444-447.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.4.444

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Abstract PDF

An ectopic cervical thymoma is an uncommon tumor of the neck displaying the same histologic features as a mediastinal thymoma. Because of its unusual location, this mass is often confused as originating from the thyroid. In this report we describe a case of cervical type AB thymoma. Aspiration cytologic smears were highly cellular and revealed irregular tissue fragments, cohesive sheets, and clusters of crowded epithelial cells intermingled with many small lymphocytes. The epithelial cells had oval and spindle shaped bland-looking nuclei and scant cytoplasm with indistinct cell borders. Mitosis, nuclear atypia, and necrosis were not observed. The cells were focally arranged in a nesting pattern. Many small lymphocytes, a few activated lymphocytes, and lymphoid tangles were seen in the background. A cytologic misdiagnosis of "possible carcinoma" was rendered. Therefore, ectopic thymoma should also be considered in fine needle aspiration cytology of a neck mass when the smear shows epithelial and lymphoid components.

Citations

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Aspiration cytology of an ectopic cervical thymoma misinterpreted as a lymphoproliferative lesion of the thyroid: A case report
YI-YING LEE, WEN-CHING WANG, CHIEN-FENG LI
Oncology Letters.2015; 10(3): 1255. CrossRef

Cytology of Follicular Dendritic Cell Sarcoma on Intraoperative Touch Imprint Smears: A Case Report.: Ju Young Song, Xian Ji Jin, Jee Young Han, Lucia Kim, In Suh Park, Joon Mee Kim, Young Chae Chu, Suk Jin Choi; Korean J Pathol. 2009;43(6):589-593.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.6.589

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Abstract PDF

Follicular dendritic cell (FDC) sarcoma is a neoplastic proliferation of FDCs. Because its cytologic findings can vary widely, both the cytomorphology and histopathology of FDC sarcoma can impose a significant diagnostic dilemma. We present cytologic features of FDC sarcoma assessed by intraoperative touch imprint. Intra-abdominal lymphadenopathies were noted in 54-year-old male with hepatitis B-virus associated liver cirrhosis. In contrast to cytologic features of classical FDC sarcoma, the tumor cells featured a large epithelioid or Reed-Sternberg cell-like shape scattered in a background with abundant inflammatory cells, which led to a mistaken diagnosis of malignant lymphoma. However, in accordance with cytologic features previously described in the literature, the tumor cells were characterized by a fragile cytoplasm with cytoplasmic processes in dendritic or reticulated patterns reminiscent of the ultrastructural features of FDC. Cytoplasmic features rendering nuclei with a tendency to form clusters or syncytial aggregates associated with reactive lymphocytes appear to be the most valuable finding in diagnosis of FDC sarcoma.

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Cytomorphology of follicular dendritic cell sarcoma: a report of 7 cases with an emphasis on the diagnostic challenges
Cody Weimholt, Jalal B. Jalaly, Cedric Bailey
Journal of the American Society of Cytopathology.2023; 12(3): 229. CrossRef
A Cytological Review of Follicular Dendritic Cell-Derived Tumors with Emphasis on Follicular Dendritic Cell Sarcoma and Unicentric Castleman Disease
José A. Jiménez-Heffernan, Cristina Díaz del Arco, Magdalena Adrados
Diagnostics.2022; 12(2): 406. CrossRef
Cytological diagnosis of follicular dendritic cell sarcoma: A case report and review of literature
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Cytopathology.2018; 29(5): 461. CrossRef

Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology in the Diagnosis of a Gastrointestinal Stromal Tumor of the Stomach: A Case Report.: Lucia Kim, Hyung Gil Kim, Young Chae Chu, In Suh Park, Suk Jin Choi, Jee Young Han, Sun Hee Kim, Don Haeng Lee, Joon Mee Kim; J Pathol Transl Med. 2008;19(2):178-182.; DOI: https://doi.org/10.3338/kjc.2008.19.2.178

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Abstract PDF: We report here a case of a gastrointestinal stromal tumor (GIST) in the stomach that was diagnosed by endoscopic ultrasound-guided fine needle aspiration cytology (EUS-FNA). A 67 year old male patient underwent regular check-ups for five years due to the presence of a submucosal tumor that was found in the fundus of the stomach incidentally. EUS-FNA was performed to evaluate the tumor, which had increased in size from 1cm to 2.8cm. A cytologic smear revealed cohesive sheets or clusters of spindle cells with elongated nuclei. Immunohistochemical staining revealed a strong positive reaction for c-kit and CD34, without any reaction for smooth muscle actin and Ki-67. Therefore, a diagnosis of GIST was made.

Original Articles

Nucleolar Organizer Regions in Normal Tissue and Hyperplastic and Neoplastic Lesions.: Joon Mee Kim, In Sun Kim, Seung Yong Paik; Korean J Pathol. 1989;23(2):208-222.

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Abstract PDF: For the identification of proliferating cells in tissue, the argyrophilic method for the demonstration of nucleolar organizer regions (Ag-NORs) have been described. To evaluate the applicability of Ag-NORs in surgical pathology, the authors have done Ag-NORs staining on 144 cases of routinely processed, formalin-fixed paraffin sections of various tissues; 15 normal tissues, 12 reactive and hyperplastic lesions, 30 benign neoplasms, 4 borderline lesions, and 83 malignant tumors. The results were summerized as follows; 1) In normal tissues, the mean numbers of Ag-NORs were highter in labile cells, especially in actively proliferating cells such as germ cells of testis, crypt epithelial cells in gastrointestinal mucosa, and lymphocytes from germinal center of tonsil and lymph node, than those of stable cells. 2) The mean numbers of Ag-NORs in reactive and hyperplastic lesions, benign neoplasms, and borderline lesions were similar to those of normal labile cells. 3) The mean numbers of Ag-NORs in carcinomas and sarcomas, (usually more than 2) significantly exceeded those of normal and non-malignant conditions. However, certain cases of carcinomas such as papillary carcinomas of thyroid, mucinous carcinoma of stomach, bronchioloalveolar carcinoma of lung, and adenoid cystic carcinoma of lung, and some of the leiomyosarcoma, malignant fibrous histiocytoma, and malignant schwannoma showed relatively lower numbers of Ag-NORs. 4) In non-Hodgkin's lymphomas, the high grade lymphomas showed more Ag-NORs than the low grade ones. From above results, it is suggested that the Ag-NORs technique is helpful in differentiation between malignant and non-malignant lesions. However, further evaluation on the significance of Ag-NORs upon the behavior of the cancer is to be made.

Prognostic Significance of Thymosin- 4 in Gastric Adenocarcinoma Patients.: Lucia Kim, Ye Ji Kim, Suk Jin Choi, In Suh Park, Jee Young Han, Young Chae Chu, Joon Mee Kim; Korean J Pathol. 2007;41(3):176-182.

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Abstract PDF: Background
: Thymosin- 4 is an actin-sequestering protein that regulates actin polymerization. It is known to be associated with cell migration, angiogenesis and wound healing, as well as with tumor metastasis.
Methods
: We immunohistochemically evaluated the thymosin- 4 expression in gastric adenocarcinoma specimens, the relationship between this protein and the pathologic features and other tumor-related proteins, and its influence on the patient outcome.
Results
: We demonstrated that 40 specimens (26.3%) of 152 gastric adenocarcinomas showed positivity for thymosin- 4. The thymosin- 4 expression was statistically associated with advanced tumor stage (p=0.010), the nodal stage (p=0.029), the TNM stage (p=0.008), and the presence of lymphovascular invasion (p=0.009). The thymosin- 4 protein expression was closely related to the positivity for VEGF (p=0.000), c-Myc (p=0.007), and cyclin D1 (p=0.005), but it was not associated with the E-cadherin (p=0.861) or -catenin (p=0.640) expressions. The median survival and disease relapse time of patients showing thymosin-4 immunoreactivity were statistically shorter than those of patients without expression. Multivariate analysis showed that the tumor stage (p=0.003), nodal stage (p=0.005), thymosin- 4 expression (p=0.019) and Lauren's classification (p=0.037) were statistically important prognostic factors for gastric adenocarcinomas.
Conclusions
: The thymosin- 4 expression might be associated with disease progression of gastric adenocarcinomas and it should be regarded as an important prognostic factor for estimating patient survival.

Case Report

Pulmonary Blastoma with Rhabdomyoblastic Differentiation: A case report with immunohistochemical and electron microscopic examination.: Joon Mee Kim, Young Chae Chu; Korean J Pathol. 1992;26(6):620-626.

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Abstract PDF: Pulmonary blastoma is a rare lung tumor composed of epithelial and mesenchymal element : the latter element may show various pattern of differentiation toward mature tissue, such as cartilage, smooth muscle, and bone. Rhabdomyoblastic differentiation in pulmonary blastoma is quire rare. In th literature, only seven cases have been reported. We report a case of pulmonary blastoma with rhabdomyoblastic differentiation which occured in a 3 year old girl. Microscopically, cytoplasmic cross-striation was present. Immunohistochemically, strong positivity for vimentin and desmin was observed. Electron microscopy demonstrated A and I bands which documented rhabdomyoblastic differentiation.

Original Articles

Immunohistochemical Expression of p53, p21, and mdm2 Proteins in Human Papillomavirus Positive and Negative Invasive Uterine Cervical Carcinomas.: In Seo Park, Hye Seung Han, Tae Sook Kim, Jee Young Han, Joon Mee Kim, Young Chae Chu, Tae Sook Hwang; Korean J Pathol. 2001;35(3):212-219.

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Abstract PDF: BACKGROUND
In the uterine cervical carcinoma, the inactivation of p53 protein by human papillomavirus(HPV) E6 protein has been reported to play a greater role in carcinogenesis than the mutation of the p53 gene. Therefore, the mutation of the p53 gene is rare. p21 and mdm2 proteins are induced by wild-type p53 protein and are involved in the cell cycle regulatory mechanism.
METHODS
Immunohistochemical staining for p53, p21 and mdm2 proteins was performed in 26 HPV-positive and 13 HPV-negative invasive cervical carcinomas together with 5 non-neoplastic cervical tissues.
RESULTS
The frequencies of the expression of p53, p21 and mdm2 proteins were 82.1%, 84.6% and 66.7%, respectively. The expression of p53 protein was less frequently demonstrated in HPV-positive cases than HPV-negative cases, which was statistically a negative correlation(p=0.018). The expression of p53 and p21 proteins was statistically significant(p=0.000).
CONCLUSIONS
p53, p21 and mdm2 proteins were highly expressed in both HPV-positive and HPV-negative cervical carcinomas. Significantly higher expression of p53 protain in HPV-negative cases necessitate a further study for investigating the role of p53 protein accumulation in carcinogenesis of HPV-negative cervical carcinomas. The relationship between the expression of p53 protein and p21/mdm2 proteins may indicate that p21 and mdm2 proteins also have a role in carcinogenesis, where p53 protein plays a fundamental role.

Fine Needle Aspiration Cytology of Diffuse Sclerosing Variant of Papillary Carcinoma of the Thyroid: A Case Report.: Joon Mee Kim, Soo Kee Min, Young Chae Chu, Mi Rim Kim, Kyung Rae Kim; J Pathol Transl Med. 2000;11(1):47-52.

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Abstract PDF: Diffuse sclerosing papillary carcinoma(DSPC), a variant of papillary carcinoma of the thyroid, is characterized by diffuse involvement of one or both thyroid lobes, and histologic features such as prominent sclerosis, intense lymphocytic infiltrate, num erous psammoma bodies, and squamous metaplasia together with the charac teristic cytoarchitectural pattern of classical papillary carcinoma. We experienced a case of fine needle aspiration cytologic(FNAC) findings of DSPC, which was con firmed by histologic examination of the thyroidectomy specimens. The patient was 26 years old female who presented with diffuse firm enlargement of the thyroid gland with enlargement of many cervical lymph nodes. FNAC smears showed numerous psammoma bodies, many lymphocytes, metaplastic squamous cells, absence of stringy colloid, and epithelial cells showing classical features of papillary carcinoma, such as nuclear grooves, intranuclear inclusions, and ground glass chromatin pattern.

Case Reports

Ectopic Hamartomatous Thymoma: A case report.: Joon Mee Kim, Nam Hee Won, Seung Yong Paik; Korean J Pathol. 1990;24(1):50-57.

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Abstract PDF: A 49-year old man was admitted to the Korea university hospital, department of surgery, for evaluation of anterior neck mass which was slowly growing for five years. His past history was unremarkable except for known hypertension for several years. Physical examination revealed high blood pressure, measuring 180 mmHg in systolic phase and 120 mmHg in diastolic phase. A soft nontender mass was palpated at anterior neck just above the sternal notch with smooth surface and its size was about 4 x 5 cm in cross. On laboratory examination, diabetic evidence such as high blood sugar (FBS 170 mg/dl, PP2hr. 234 mg/dl) and glucosuria. The CBC finding suggested polycythemia with high hemoglobin (18.0 g/dl) and hematocrit (54%) levels. The differential count and platelet count were within normal limits.

Achondrogenesis Type 2: An autopsy case.: Joon Mee Kim, Young Chae Chu, Soo Kee Min, Hee Jeung Cha, Je Geun Chi; Korean J Pathol. 1997;31(5):482-488.

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Abstract PDF: Achondrogenesis type 2 is a lethal form of congenital skeletal dysplasia characterized by severe short-limbed dwarfism, decreased vertebral ossification and normal ossification of the skull. We report an autopsy case of achondrogenesis type 2 in a female fetus terminated at 29 weeks of gestation. External morphology revealed a relatively large head, short upper and lower extremities, short neck, and distended abdomen. The x-ray finding showed normal calvarial ossification, hypoplastic ilium and unossified ischium, and metaphyseal flares of the femur and tibia. Histologically, chondrocytes were large and irregular with increased vascularity.

Original Article

Correlation between Tumor Angiogenesis (Microvessel Density), Metastasis and Tumor Cell Proliferation in Colorectal Carcinomas.: Young Chae Chu, Joon Mee Kim; Korean J Pathol. 1997;31(6):517-526.

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Abstract PDF: Tumor angiogenesis has been shown to be associated with metastatic potentials in breast, lung and prostatic carcinomas. The relation between tumor angiogenesis and metastatic potentials in colorectal cancer has not been established to date. We analysed 66 selected patients with colorectal carcinomas (37 with and 29 without nodal metastases) for the microvessel density, tumor proliferation activity, and the clinicopathologic parameters including size, stage, histologic grade, growth pattern, presence of angioinvasion, perineural invasion and lymph node metastasis. For evaluation of microvessel density and tumor proliferative activity, the primary tumors were immunohistochemically stained for CD31 and PCNA. The mean microvessel counts (MVC) per 200X field were 99.27+/-23.28 and 131.35+/-31.48 in node-negative and node-positive patients, respectively. The PCNA index was 39.41+/-5.63% and 56.60+/-7.09% in node-negative and node-positive patients, respectively. MVC and PCNA index were higher in tumors with nodal metastasis (p=0.002, p<0.001), and also correlated each other (sr=0.33, p=0.007). Higher microvessel counts were seen in tumors with advanced stage (p=0.016). Tumor proliferation activity assessed by PCNA immunostaining was significantly higher in tumors with advanced stage, perineural invasion, angioinvasion, poor differentiation and larger size. From these results, MVC and PCNA index in colorectal carcinomas are assumed to be valuable prognostic parameters. Thus assessment of tumor angiogenesis and tumor cell proliferation in colorectal carcinomas may be helpful for the patients in need of aggressive therapy.

Case Report

Fine Needle Aspiration Cytology of Alveolar Soft Part Sarcoma: A Case Report .: Hye Seung Han, In Seo Park, Jee Young Han, Joon Mee Kim, Young Bae Kim, Tae Sook Hwang, Young Chae Chu; J Pathol Transl Med. 2000;11(2):115-119.

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Abstract PDF: Alveolar soft part sarcoma is a rare soft tissue tumor. Few cases of fine needle aspiration cytology have been reported in the literature. We experienced a case of recurrent alveolar soft part sarcoma of the right thigh diagnosed by fine needle aspiration cytology in a 47-year-old man. Cytologic findings showed single cells and clusters associated with thin walled vasculature in a distinct pseudo-alveolar pattern. The tumor cells exhibited round or ovoid abundant granular cytoplasm and large pleomorphic nuclei with prominent central nucleoli.

Original Article

Diagnostic Sensitivity of Sputum and Bronchial Washing Cytology in Bronchogenic Carcinomas Confirmed by Bronchoscopic Biopsy .: Joon Mee Kim, Soo Kee Min, Young Chae Chu, Chul Ho Cho; J Pathol Transl Med. 2001;12(1):17-23.

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Abstract PDF: To evaluate the role of sputum and bronchial washing for the diagnosis of lung carcinoma, we studied the sensitivity of both cytologic techniques using the biopsy confirmed cases from 228 patients. Among them, 123 cases were squamous cell carcinomas, 42 cases were adenocarcinomas, 48 cases were small cell carcinomas, one case was large cell carcinoma, and 14 cases were other types of carcinoma including poorly differentiated carcinomas. Three hundreds and ninety two sputa and 173 sputa were obtained in the pre- and post- bronchoscopic periods. Bronchial washing had been taken once in each patient. The overall sensitivity of the sputum cytology was 0.52 and that of the bronchial washing 0.63, while it increased to 0.83 when a combination of both techniques. Squamous cell carcinomas were diagnosed to the great extent in which sensitivities were 0.59 and 0.74, in sputum and bronchial washing, respectively. The post-bronchoscopic sputa showed higher sensitivity (0.44) than pre-bronchoscopic sputa (0.30). The sensitivity of sputa increased from 0.34 to 0.49 when three samples were examined compared to the single examination. The accuracy of cell typing was 94.0% in sputa and 93.8% in bronchial washing. Repeated sputum examination including post- bronchoscopic sputa is warranted to improve sensitivity and a complementary role of both cytologic techniques can be postulated by these data.

Case Report

Rhinoscleroma: A case report.: Joung Ho Han, Joon Mee Kim, In Sun Kim, Seung Young Paik; Korean J Pathol. 1990;24(2):166-170.

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Abstract PDF: Rhinoscleroma, or scleroma, is a chronic, slowly progressing granulomatous disease involving the upper respiratory tract, especially the nasal vestibules, choanae, pharynx, and larynx. Almost certainly the causative agent is Klebsiella rhinoscleromatis. The disease occurs frequently in Eastern Europe, the Middle East, and parts of Latin America, but it is hard to find such case in Korea. We prisent a case of rhinoscleroma involving the nasal vestibule in a 18-year-old male who was admitted due to nasal obstruction for 5 years and epistaxis for 2 months. The resected specimen was an irregular polypoid mass with relatively firm consistency and measured 3 cm in the largest diameter. Microscopically, the lesion was characterized by extensive fibrosis and inflammatory cell infiltration. The infiltrates consisted of predominantly lumphocytes, plasma cells, foamy or granular histiocytes which were singly scattered or grouped in clusters. In the cytoplasm of the histiocytes, round slightly basophilic bodies were noted. Warthin-Starry satin showed short positive rods within the cytoplasm of the cell (Mikulicz cell). Electron microscopically, the cytoplasm of Mikulicz cells contained large, round or irregular shaped clear vacuoles in which numerous Klebsiella bacilli attached to the boundaries of the vaculoes were noted. With higher magnifications, the bacilli were seen as roung or rod-shaped organisms.

Original Article

Peripheral neuroblastoma of the ulnar nerve:diagnosis by fine needle aspiration cytology.: Young Chae Chu, Joon Mee Kim; J Pathol Transl Med. 1993;4(1):45-51.

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Abstract PDF: No abstract available.

Multicenter Study

Porposal for Creating a Guideline for Cancer Registration of the Gastrointestinal Tumors (I).: Mee Yon Cho, Yun Kyung Kang, Kyoung Mee Kim, Hee Kyung Chang, Hee Jin Chang, Mee Soo Chang, Joon Mee Kim, Dae Young Kang, Chanil Park, Jin Hee Sohn; Korean J Pathol. 2008;42(3):140-150.

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Abstract PDF: BACKGROUND
Cancer registries are fundamental for cancer control and multicenter collaborative research. However, there have been discrepancies among pathologists in classifying cancer and assigning the codes according to the International Classification of Disease Oncology 3 (ICD-O3). To improve the quality of cancer registries as well as to prevent the conflict with medical insurance compensation, a guideline for the coding of cancer is mandatory.
METHODS
AND RESULTS: Funded by the Management Center for Health Promotion, 40 members of the Gastrointestinal Pathology Study Group and the Cancer Registration Committee of the Korean Society of Pathologists participated in the 1st workshop for gastrointestinal tumor registration. The subjects of gastric epithelial tumor, intramucosal carcinoma of the colon, carcinoid tumor, gastrointestinal stromal tumor and appendiceal mucinous tumor were discussed to create a guideline. A survey to obtain consensus for the guideline proposed by the workshop was carried out by the members of the Korean Society of Pathologists and 240 members completed the questionnaire.
CONCLUSION
Although there are some issues to be discussed further, such as coding of high grade dysplasia/adenoma and intramucosal carcinoma of stomach and colon, the members agreed upon most parts of the proposed guideline. Therefore, we suggest using the ICD-O3 coding guideline for gastrointestinal tumor.

Original Article

Fine needle aspiration cytology of carotid body paraganglioma-a case report.: Joon Mee Kim, Young Chae Chu; J Pathol Transl Med. 1993;4(1):77-80.

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Abstract PDF: No abstract available.

Case Report

Clear Cell Meningioma.: Hee Jeung Cha, Soo Kee Min, Joon Mee Kim, Young Chae Chu; Korean J Pathol. 1997;31(8):782-787.

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Abstract PDF: Clear cell meningioma is a recently recognized morphologically unique entity. It shows no sex predilection, affects primarily the lumbar region, and the cerebellopontine angle. Despite its benign appearance, it may be aggressive, particularly in intracranial cases. All lesions are moderately cellular, with the exception of stromal hyalinization. The tumor consists largely of a sheet- like or somewhat lobular pattern of polygonal cells, the cytoplasm of which is clear. No close association is noted between the recurrence or the clinical outcome and factors such as mitotic activity, the PCNA index, and the DNA ploidy status. But the MIB-1 proliferation index is appreciably higher in recurrent tumors. We experienced a case of clear-cell meningioma showing a characteristic histologic finding. A 39-year-old man was admitted due to the recent onset of right-sided, facial-nerve palsy, left hemiparesis and general weakness. A CT scan of the head showed a well defined mass in the petroclival area. After surgical resection, the patient was in good condition, but 1 year later symptoms recurred. A CT scan of the head showed a huge, recurrent petroclival tumor with adhesion to the surrounding brain parenchyme.

Original Article

Expression of Maspin Protein in Ductal Hyperplasia, Intraductal Carcinoma and Invasive Ductal Carcinoma of the Breast.: Young Chae Chu, In Seo Park, Yoon Ju Kim, Joon Mee Kim, Hye Seung Han, Jee Young Han, Young Bae Kim; Korean J Pathol. 1999;33(8):614-619.

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Abstract PDF: Maspin is a recently described gene with tumor suppressor activity. The gene product is a 42 kD protein with homology to the serpin family of protease inhibitors and may play a role as an inhibitor of tumor cell invasion. The prior observation that invasive breast cancers and their metastases showed decreased maspin protein expression by immunostaining supports this speculation. However, the role of maspin in breast cancer progression has not been studied in detail. We, therefore, studied maspin protein expression in a series of hyperplasia, atypical ductal hyperplasia, intraductal carcinoma and invasive carcinomas. Immunohistochemical staining (IHC) for maspin was performed on paraffin sections of 136 breast specimens using a commercially available monoclonal antibody. Among the 106 cases studied were 36 moderate/florid ductal hyperplasia, 11 atypical ductal hyperplasia (ADH), 29 intraductal carcinoma (IDC) (4 low grade, 13 intermediate grade, 12 high grade) and 30 invasive ductal carcinomas. Thirty cases of normal breast were also studied as control group. IHC stains were scored using a semiquantitative scoring system. The mean IHC scores for maspin for normal, moderate/florid hyperplasia, atypical ductal hyperplasia, intraductal carcinoma, and invasive carcinoma were 5.51 1.30, 7.36 0.72, 3.82 1.60, 4.48 2.69, 3.97 3.30, respectively. These scores for each category were statistically significant (p<0.05), except between ADH and IDC. Maspin protein expression was increased in most cases of moderate/florid hyperplasia, while maspin expression was more heterogeneous in ADH and IDC. In high grade IDC, maspin protein expression was stronger than low and intermediate grade IDC, and this suggests the possibility of a compensatory cellular response against the forces driving further tumor progression. Two thirds of invasive ductal carcinomas expressed maspin protein weakly and focally. All metastatic carcinomas of lymph nodes were negative for maspin. It is possible that high grade IDC with strong maspin expression may represent a subset less likely to progress to invasive cancer. This speculation merits investigation in clinical outcome studies.

Case Reports

Angiodysplasia Arising in the Bowels: Two cases report.: Soo Kee Min, Hee Jeung Cha, Joon Mee Kim, Young Chae Chu; Korean J Pathol. 1997;31(12):1308-1313.

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Abstract PDF: Gastrointestinal angiodysplasia is a distinct disease entity which causes frequent gastrointestinal bleeding. It predominantly arises at the stomach and duodenum in the upper gastrointestinal tract and cecum and ascending colon in the lower gastrointestinal tract. The general histological finding of the angiodysplasia is a submucosal vascular ectasia and tortuosity. We have experienced two cases of the intestinal angiodysplasia. The first case occurred on a jejunum in a 22-year-old woman who had anemia. The second case occurred on a sigmoid colon in a 59-year-old man who had constipation. In addition to the general histologic finding of the angiodysplasia, the microscopic findings of the first case revealed some capillary hemangioma-like areas; and in the second case, there was a marked ischemic change and the thickening of the wall.

Pleomorphic Hyalinizing Angiectatic Tumor of Soft Parts: A Case Report.: Young Chae Chu, Sun Keun Choi, In Suh Park, Hye Seung Han, Jee Young Han, Joon Mee Kim; Korean J Pathol. 2002;36(3):195-198.

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Abstract PDF: A case of rare pleomorphic hyalinizing angiectatic tumor (PHAT) of soft parts is reported. A 35-year-old woman presented with a subcutaneous solid mass in the left inguinal area, which had been present for 3 months, was presented to us. The tumor was histologically characterized by sheets of mitotically inactive oval and pleomorphic cells, mono-and multinucleated giant cells, intranuclear cytoplasmic inclusions, and prominent clusters of thinwalled ectatic vessels with perivascular hyalinization. A focal hemangiopericytoma-like vascular pattern, pseudovascular spaces, stromal collagen with degenerative change and abundant mast cells were observed. The tumor cells were reactive for vimentin and CD34. This tumor shared several features with malignant fibrous histiocytoma, ancient schwannoma, giant cell angiofibroma, giant cell fibroblastoma and solitary fibrous tumor. The patient was well with no evidence of disease for 10 months.

Fine Needle Aspiration Cytologic Findings of Fibromatosis Colli: A Report of Three Cases.: In Suh Park, Lucia Kim, Suk Jin Choi, Jee Young Han, Joon Mee Kim, Young Chae Chu, Sun Geun Choi; J Pathol Transl Med. 2005;16(1):61-65.

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Abstract PDF: Fibromatosis colli is a benign fibrous tissue proliferation of sternocleidomastoid muscle, which is usually observed during the first month of life, often associated with congenital torticollis. It should be differentiated from other neck masses in infants because the usual initial treatment of fibromatosis colli is conservative management and invasive therapy should be avoided. Fine needle aspiration cytology provides an excellent minimally invasive diagnostic way for evaluation of infantile neck masses. We describe three cases of fibromatosis colli diagnosed by fine needle aspiration cytology. All of them were younger than one month and presented as a neck mass. Clinical impressions were malignant tumors in two cases and fibromatosis colli in one case. Fine needle aspiration cytology revealed benign and mature fibroblasts and atrophic striated muscle fibers. The cytologic diagnosis was fibromatosis colli or benign fibous lesion.

Original Article

Gangliocytic Paraganglioma.: Joon Mee Kim, Suk Jin Choi, Lucia Kim, In Suh Park, Jee Young Han, Young Chae Chu, Hyung Gil Kim, Sun Geun Choi; Korean J Pathol. 2005;39(6):428-432.

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Abstract PDF: Gangliocytic paraganglioma (GP) is a rare benign tumor that is usually seen in the duodenum. It shows unique histologic features that are composed of a carcinoid or paraganglioma-like appearance, ganglion cells, and Schwann cells. The common presenting symptoms are abdominal pain, gastrointestinal bleeding and obstruction. The lesion can sometimes be asymptomatic and they are discovered incidentally. We experienced a case of incidentally found GP in a 73 year-old-man who had a colon cancer with liver metastasis. During the preoperative workup, a submucosal tumor was found in the duodenal papilla. The frozen diagnosis of the duodenal mass was GP, which was confirmed by the permanent sections and immunohistochemical staining. Pathologists should be alert to recognize and diagnose this rare, but benign disease, especially in the patient suffering with gastrointestinal cancer.

Case Report

Touch Imprint Cytology of Merkel Cell Carcinoma: A Case Report.: Suk Jin Choi, Lucia Kim, In Suh Park, Jee Young Han, Joon Mee Kim, Young Che Chu; J Pathol Transl Med. 2005;16(2):93-97.

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PDF

Original Article

Expression of Insulin-like Growth Factor-I-Receptor in Colorectal Adenomas and Carcinomas.: Young Chae Chu, Hye Seung Han, Jee Young Han, Joon Mee Kim, Young Bae Kim, Tae Sook Hwang; Korean J Pathol. 2000;34(3):199-207.

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Abstract PDF: The activation of the insulin-like growth factor-I-receptor system (IGF-IR) has recently emerged as critical events in transformation and tumorigenicity of several human tumors. In this study we investigated the expression of IGF-IR in 33 colorectal adenomas, 88 primary colorectal carcinomas, and 30 normal colonic mucosa adjacent to the carcinoma. Immunohistochemical staining (IHC) for IGF-IR was performed on paraffin embedded sections using an anti-IGF-IR rabbit polyclonal antibody. IHC stains for IGF-IR were scored using a semiquantitative scoring system. The relationship of IGF-IR staining to clinicopathologic variables and proliferating cell nuclear antigen (PCNA) staining was also analysed. The mean IHC scores for IGF-IR of normal glands, adenoma, intramucosal carcinoma, node-negative carcinoma, and node-positive carcinoma were 0.41 0.96, 0.76 1.23, 2.0 1.48, 2.83 2.0 and 5.93 1.58, respectively. These scores for each category were statistically significant except between normal glands and adenoma and between intramucosal carcinoma and node-negative carcinomas. The mean PCNA indexes of normal glands, adenoma, intramucosal carcinoma, node-negative carcinoma, and node-positive carcinoma were 2.48 2.60, 6.94 11.03, 27.21 11.42, 43.36 9.9 and 57.60 10.01, respectively. The PCNA index for each category was statistically significant except between normal and adenoma. IGF-IR scores and PCNA indexes were higher with tumor progression and also correlated each other (sr=0.65, p=0.0001). Higher IGF-IR scores and PCNA indexes were seen in tumors with advanced stage, infiltrative growth pattern, poor differentiation, nerve invasion, lymphovascular invasion, and moderate fibrosis. Our results suggest that IGF-IR plays an important role in tumorigenicity and tumor progression.

Case Reports

Composite Hemangioendothelioma: A Case Report.: Young Chae Chu, Suk Jin Choi, In Suh Park, Lucia Kim, Jee Young Han, Joon Mee Kim; Korean J Pathol. 2006;40(2):142-147.

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Abstract PDF: Composite hemangioendothelioma (CHE) is a recently described vascular tumor of low-grade malignancy. We report a case of CHE in an 18-year-old woman who presented with a 2-month history of an enlarging palpable mass in the left axilla. Grossly, the excised tumor was relatively circumscribed, nodular, firm, and soft. It measured 6.0 x 4.5 x 4.0 cm. The cut surface revealed a whitish gray solid area and a dark red to tan cystic area containing necrotic material. Histologically, the tumor demonstrated variably intermixed benign and malignant vascular components. The benign components showed features of an arteriovenous malformation, capillary hemangioma, spindle cell hemangioma and cavernous hemangioma. The malignant components were composed of areas resembling retiform hemangioendothelioma, epithelioid hemangioendothelioma, Kaposiform hemangioendothelioma, and angiosarcoma. The angiosarcoma component showed a mixed epithelioid and spindle shaped cell morphology with moderate differentiation. A nearly imperceptible transition between the benign and malignant components was noted.

Inflammatory Myofibroblastic Tumor of the Stomach: A Case Report.: Joon Mee Kim, In Suh Park, Lucia Kim, Suk Jin Choi, Jee young Han, Young Chae Chu, Kyoung Rae Kim; Korean J Pathol. 2006;40(2):148-150.

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Abstract PDF: Inflammatory myofibroblastic tumor of the stomach is a rare tumor-like, benign disease with an uncertain pathogenesis. A 15-year-old male presented with epigastric pain. Endoscopic ultrasonography revealed a 2.3 cm sized ovoid intramuscular mass in the lower body of the stomach at the lesser curvature. Histologically, the tumor was composed of smooth muscle actin positive- and vimentin positive spindle cells and there were a large number of lymphocytes, plasma cells and histiocytes in the fibrotic background. The spindle cells were also positive for ALK1, but negative for EBV in situ hybridization.

Original Article

Cytologic Evaluation of Adenocarcinoma and its Mimics in Sputum and Bronchial Washings.: Young Chae Chu, In Suh Park, Suk Jin Choi, Lucia Kim, Jee Young Han, Joon Mee Kim, Jung Ae Park; J Pathol Transl Med. 2007;18(1):36-45.

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Abstract PDF: OBJECTIVE: To identify key cytologic features for diagnosis of adenocarcinoma and morphologic differentiation from reactive/reparative respiratory epithelium. STUDY DESIGN: The cytomorphologic features of 145 pulmonary cytology specimens (sputum and bronchial washing), which included 117 histologically proven adenocarcinomas and 28 non-neoplastic lesions, cytologically diagnosed as atypia and suspicious for malignancy (adenocarcinoma) were reviewed retrospectively. We analyzed 11 morphologic criteria in pulmonary cytologic specimens.
RESULTS
Over 110 of 117 cases of adenocarcinomas revealed nuclear membrane irregularities, non-cohesive cells, single atypical cells, moderate to markedly enlarged nuclei and an increased nuclear/cytoplasmic (N/C) ratio. Chromatin clearing, chromatin heterogeneity and hyperchromasia were seen in 102, 99 and 97 cases, respectively. All 28 cases involving non-neoplastic lesions revealed hyperplastic reactive pneumocytes, hyperplastic reactive bronchial epithelium, or degenerating macrophages. The non-neoplastic lesions revealed a small number of atypical cell clusters and paucity or absence of atypical single cells.
CONCLUSION
The most important morphologic features for diagnosis of adenocarcinoma are nuclear membrane irregularities, non-cohesive cells, single atypical cell, moderate to markedly enlarged nuclei and increased N/C ratio. Chromatin clearing, chromatin heterogeneity and hyperchromasia were also helpful features, while pleomorphism and prominent nucleoli were less valuable.

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