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Case Report
- Papillary Neoplasm of the Endolymphatic Sac: A report of two cases.
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Jai Hyang Go, Yoon Jung Choi, Tae Seung Kim, Chan Il Park
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Korean J Pathol. 1996;30(2):150-154.
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Abstract
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- Papillary tumor of the temporal bone or middle ear has been recognized as an aggressive neoplasm because of its invasive growth pattern. The site of origin is controversial so that most cases have been reported under various diagnostic terms. Recently, Heffner(1989) suggested that the endolymphatic sac is a possible site of origin, because the tumor resembles the endolymphatic sac in several aspects. We report two such cases. One patient was a 34-year-old female presenting with tinnitus and hearing difficulty for 1 year.
Temporal bone CT revealed extensive bone destruction by the tumor which was located in the posterolateral aspect of temporal bone. The other patient was a 56-year-old female who complained of tinnitus, dizziness and otalgia for 2 years. Cranial MR imaging showed an irregularly marginated mass in the left jugular fossa with extension to the petrous bone. Histologically, both cases showed a papillary pattern and locally destructive growth that are typical of papillary tumor of the endolymphatic sac. The papillae were lined by a single layer of bland-looking cuboidal to low columnar cells. Immunohistochemically the lining cells expressed cytokeratin, epithelial membrane antigen, neuron specific antigen and in one case, S-100 protein, supporting the thesis that these neoplasms might be of endolymphatic sac origin.
Original Article
- Angiogenensis and Overexpression of p53 Gene Produc in Brain Tumor.
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Jeong Yun Shim, Ho Guen Kim, Tai Seung Kim
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Korean J Pathol. 1997;31(1):23-33.
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Abstract
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- Angiogenesis depends on the net balance between positive and negative angiogenic factors. Tumor cells are angiogenic resulting from increased production of positive factors and decreased production of negative factors. Among these, vascular endothelial growth factor and glioma- derived angiogenesis inhibiting factor are related to glioblastoma multiforme. The p53 gene is more frequently mutated than any other known oncogene or tumor suppressor gene in human tumors including glioblastoma multiforme. Angiogenesis is reported to be controlled by p53 regulation in recent studies. To examine the effect of p53 overexpression on angiogenesis in glioblastoma multiforme, we performed immunohistochemical staining in 51 cases of glioblastoma multiforme, using monoclonal antibodies to p53 protein and factor VIII. 20 cases of low grade astrocytoma were used as control. p53 overexpression was present in 15(75%) of 20 cases of low grade astrocytoma and the mean vessel count was 37.7+/-9.9 at x200 field and 17.5+/-5.8 at x400 field. p53 overexpression was present in 35(68%) of 51 cases of glioblastoma multiforme and the mean vessel count was 91.9 45.8 at x200 field and 40.7 19.1 at x400 field. Mean vessel count in low grade astrocytoma with p53 overexpression was 39.4 10.2 at x200 field and 18.9 5.7 at x400 field, while in cases without p53 overexpression it was 32.4+/-7.6 at x200 field and 13.2 3.5 at x400 field. Mean vessel count in glioblastoma multiforme with p53 overexpression was 94.5+/-51.8 at x200 field and 42.1+/-16.8 at x400 field, while in cases without p53 overexpression it was 86.1+/-29.5 at x200 field and 37.1+/-16.8 at x400 field. The mean survival time was 12.4 months in the 39 cases of glioblastoma multiforme in which follow-up studies were possible. Significant prognostic factors were age, p53 overexpression and adjuvant therapy. These results show that p53 gene mutation is one of the many contributing factors to angiogenesis in glioblastoma multiforme. In addition, other oncogenes and tumor suppressor genes, as well as growth factors may be involved. Age, p53 overexpression and adjuvant therapy proved to be significant prognostic factors, while microvessel density was not.
Case Report
- Non-Salivary Type Adenocarcinoma of the Sinonasal Tract A case report with low and high grade histologies.
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Jai Hyang Go, Min Chul Lee
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Korean J Pathol. 2000;34(1):85-87.
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Abstract
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- Non-salivary type adenocarcinoma of the sinonasal tract is a rare entity and includes low grade and high grade adenocarcinomas, which show somewhat different clinical and histological features. We report a case of non-salivary type adenocarcinoma occurring in a 55-year-old man. Computed tomography showed a soft tissue mass in right nasal cavity and ethmoid sinus, which extended to the nasopharynx. Removed mass showed both high grade and low grade adenocarcinomatous areas, which have different histology from usual salivary type tumor. The high grade area mimicked intestinal adenocarcinoma and low grade area was similer to adenoma because of very well differentiated tumor glands.
Original Article
- Role of Cytologic Scoring System in Minimizing "Gray Zone" in Breast Aspiration Cytology.
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Jung Yeon Kim, Kyung Ja Cho, Seung Sook Lee, Shin Kwang Khang
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Korean J Cytopathol. 1996;7(1):12-22.
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Abstract
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- Fine needle aspiration(FNA) has been quite successful in identifying benign and malignant breast lesions, but a "gray zone" exists. A total of 697 FNAs of breast were performed at Korea Cancer Center Hospital for a period of one year.
One hundred and eleven of the 697 FNAs were diagnosed as atypical or suspicious for malignancy. Among them, we reviewed 74 FNAs, in which histologic diagnoses were made, and applied cytologic grading system proposed by masood et al.(1990) to evaluate the usefulness of this system in minimizing the size of gray zone. Technical problem was responsible for equivocal diagnoses in 19 FNAs. Of the remaining 55 FNAs, 18 were benign and 37 were mali. Among benign conditions, fibroadenoma(5 cases) and fibrocystic disease with fibroadenomatous feature(3 cases) constituted the largest groups. The majority of malignant conditions were infiltrating ductal carcinoma(29 cases); however, those low grade carcinomas including tubular carcinoma(3 cases), cribriform carcinoma(2 cases), and mucinous carcinoma(2 cases) occupied a relatively large proportion Cytologic grading system was quite useful in minimizing the size of gray zone. The scores of 27 out of 29 usual infiltrating ductal carcinomas belonged to the group of cytologic malignancy, however, only 2 out of 7 low grade carcinomas got scores of malignancy. FNA from fibroadenoma or fibrocystic disease with fibroadenomatous features showed a tendency toward high scores. Experience of the cytopathologist and famillarity with cytologic alteration in breast disease cannot be overemphalized.
Case Report
- Fine Needle Aspiraton Cytology of Polymorphous Low Grade Adenocarcinoma in the Hard Palate: A Case Report .
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Wan Seop Kim, Seok Hoon Jeon, Eun Kyung Hong, Moon Hyang Park, Jung Dal Lee
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Korean J Cytopathol. 1998;9(2):181-186.
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Abstract
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- Polymorphous low grade adenocarcinoma(PLGA) is a rare malignant tumor of the salivary gland. It is characterized by diverse histology, bland-looking cytology, indolent behavior and favorable prognosis. The fine needle aspiration cytologic features of PLGA are described. The aspirates from the hard palate in a 33-year-old woman showed cellular smear composed of monotonous small round to oval cells with scanty cytoplasm. Papillary, tubular and cell ball arrangements with characteristic dense stromal spheres were recognized. PLGA could be suggested by fine needle aspiration cytology, if one encountered cellular smear with various architectures and uniform bland-looking cytologic feature.
Original Article
- Cytologic Features of Papillary Immature Metaplasia of Uterine Cervix.
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Hye Sun Kim, Mee Im Seon, Yee Jung Kim, Hy Sook Kim
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Korean J Cytopathol. 2002;13(1):21-27.
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Abstract
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- Papillary immature metaplasia (PIM) of the uterine cervix (immature condyloma) is a subset of low grade squamous intraepithelial lesion (LSIL) which is frequently associated with human papilloma virus (HPV) types 6 and 11. The histologic features of PIM include filiform papillae lined by evenly spaced immature metaplastic-type cells with frequent nucleoli, mild anisokaryosis, and a low mitotic index. To characterize the cytologic changes associated with PIM, we analyzed 14 cases of PIM from our file. We reviewed biopsy slides and the cervicovaginal smears taken proximate to the time of biopsy. Histologically, nine cases had either flat condyloma (7 cases) or high grade squamous intraepithelial lesion (HSIL) (2 cases). Cytologic changes included cells in various stages of maturation with karyomegaly (14 cases), cells with irregularities in the nuclear membrane (13 cases), intermediate cells with karyomegaly(13 cases), cells with binucleation (13 cases), and aborted koilocytes (11 cases). Cervicovaginal smears from all cases were interpreted as atypical squamous cells of undetermined significance (ASCUS), NOS or ASCUS, rule out squamous intraepithelial lesion (SIL) or LSIL in two cases with flat condyloma or HSIL in a case with severe dysplasia.
PIM is a distinct histologic entity that can present with a spectrum of cytologic findings, but cytologic findings may resemble variable reactive conditions and immature HSIL.
Therefore, it is difficult to diagnose PIM by cytology alone. However, the meticulous efforts for making the cytologic diagnoses which can induce active management of patients are recommended because PIM is a variant of LSIL and frequently has a flat condyloma or HSIL.
Case Report
- Intraosseous Well Differentiated Osteosarcoma: A case report.
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Mee Hye Oh, So Young Park, Yeon Lim Suh, Shin Khang Kang
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Korean J Pathol. 1992;26(6):627-631.
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Abstract
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- Well differentiated osteosarcomas are variants of osteosarcoma composed mainly of fibrous and osseous tissue with minimal cystologic atypia. This tumor may be misinterpretated as a benign lesion if the radiologic and clinical features are not taken into account. We report a typical case of intraosseous well differentiated osteosarcoma occuring in the left distal femur of a 58-year-old woman. Radiologically, it appered as an ill-defined lesion with a mixture of sclerotic and osteolytic ares. But there was a lack of highly destructive appearance of conventional osteosarcoma. Grossly, the mass occupied a metaphysis of the distal femur with extension into the diaphysis and epiphysis. Multifocal cortical destruction and sclerosis were also associated.
Histologically, the mass showed typical features of intraosseous well differentiated osteosarcoma. There were various patterns of osteoid deposits and bone formation mimicking those of fibrous dysplasia, nonossifying fibroma or parosteal osteosarcoma.
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