Journal of Pathology and Translational Medicine

Review

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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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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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;[Epub] 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
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Pathological Interpretation of Gastric Tumors in Endoscopic Submucosal Dissection
Jung Yeon Kim
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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
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Original Articles

Prognostic Significance of a Micropapillary Pattern in Pure Mucinous Carcinoma of the Breast: Comparative Analysis with Micropapillary Carcinoma: Hyun-Jung Kim, Kyeongmee Park, Jung Yeon Kim, Guhyun Kang, Geumhee Gwak, Inseok Park; J Pathol Transl Med. 2017;51(4):403-409. Published online June 9, 2017; DOI: https://doi.org/10.4132/jptm.2017.03.18

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Abstract PDF

Background
Mucinous carcinoma of the breast is an indolent tumors with a favorable prognosis; however, micropapillary features tend to lead to aggressive behavior. Thus, mucinous carcinoma and micropapillary carcinoma exhibit contrasting biologic behaviors. Here, we review invasive mucinous carcinoma with a focus on micropapillary features and correlations with clinicopathological factors.
Methods
A total of 64 patients with invasive breast cancer with mucinous or micropapillary features were enrolled in the study. Of 36 pure mucinous carcinomas, 17 (47.2%) had micropapillary features and were termed mucinous carcinoma with micropapillary features (MUMPC), and 19 (52.8%) had no micropapillary features and were termed mucinous carcinoma without micropapillary features. MUMPC were compared with 15 invasive micropapillary carcinomas (IMPC) and 13 invasive ductal and micropapillary carcinomas (IDMPC).
Results
The clinicopathological factors of pure mucinous carcinoma and MUMPC were not significantly different. In contrast to IMPC and IDMPC, MUMPC had a low nuclear grade, lower mitotic rate, higher expression of hormone receptors, negative human epidermal growth factor receptor 2 (HER2) status, lower Ki-67 proliferating index, and less frequent lymph node metastasis (p < .05). According to univariate analyses, progesterone receptor, HER2, T-stage, and lymph node metastasis were significant risk factors for overall survival; however, only T-stage remained significant in a multivariate analysis (p < .05).
Conclusions
In contrast to IMPC and IDMPC, the micropapillary pattern in mucinous carcinoma does not contribute to aggressive behavior. However, further analysis of a larger series of patients is required to clarify the prognostic significance of micropapillary patterns in mucinous carcinoma of the breast.

Citations

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Pure mucinous adenocarcinoma of the breast with the rare lymphoplasmacytic infiltration: A case report with review of literature
Yash Hasmukhbhai Prajapati, Vishal Bhabhor, Kahan Samirkumar Mehta, Mithoon Barot, Husen Boriwala, Mohamed Omar
Clinical Case Reports.2024;[Epub] CrossRef
Expression of autocrine motility factor receptor (AMFR) in human breast and lung invasive micropapillary carcinomas
Jing Xu, Hongfei Ma, Qi Wang, Hui Zhang
International Journal of Experimental Pathology.2023; 104(1): 43. CrossRef
The Spectrum of Mucinous Lesions of the Breast
Upasana Joneja, Juan Palazzo
Archives of Pathology & Laboratory Medicine.2023; 147(1): 19. CrossRef
Pure Mucinous Carcinoma of the Breast: Radiologic-Pathologic Correlation
Cherie M Kuzmiak, Benjamin C Calhoun
Journal of Breast Imaging.2023; 5(2): 180. CrossRef
On Ultrasonographic Features of Mucinous Carcinoma with Micropapillary Pattern
Wei-Sen Yang, Yang Li, Ya Gao
Breast Cancer: Targets and Therapy.2023; Volume 15: 473. CrossRef
Micropapillary Breast Carcinoma: From Molecular Pathogenesis to Prognosis
Georgios-Ioannis Verras, Levan Tchabashvili, Francesk Mulita, Ioanna Maria Grypari, Sofia Sourouni, Evangelia Panagodimou, Maria-Ioanna Argentou
Breast Cancer: Targets and Therapy.2022; Volume 14: 41. CrossRef
Mucinous carcinoma of the breast: distinctive histopathologic and genetic characteristics
Minjung Jung
Kosin Medical Journal.2022; 37(3): 176. CrossRef
Triple-Positive Breast Carcinoma: Histopathologic Features and Response to Neoadjuvant Chemotherapy
Jennifer Zeng, Marcia Edelweiss, Dara S. Ross, Bin Xu, Tracy-Ann Moo, Edi Brogi, Timothy M. D'Alfonso
Archives of Pathology & Laboratory Medicine.2021; 145(6): 728. CrossRef
HER2 positive mucinous carcinoma of breast with micropapillary features: Report of a case and review of literature
Dinesh Chandra Doval, Rupal Tripathi, Sunil Pasricha, Pankaj Goyal, Chaturbhuj Agrawal, Anurag Mehta
Human Pathology: Case Reports.2021; 25: 200531. CrossRef
Sonographic Features of Pure Mucinous Breast Carcinoma With Micropapillary Pattern
Wu Zhou, Yong-Zhong Li, Li-Min Gao, Di-Ming Cai
Frontiers in Oncology.2021;[Epub] CrossRef
Clinicopathologic characteristics of HER2-positive pure mucinous carcinoma of the breast
Yunjeong Jang, Hera Jung, Han-Na Kim, Youjeong Seo, Emad Alsharif, Seok Jin Nam, Seok Won Kim, Jeong Eon Lee, Yeon Hee Park, Eun Yoon Cho, Soo Youn Cho
Journal of Pathology and Translational Medicine.2020; 54(1): 95. CrossRef
Mucinous carcinoma with micropapillary features is morphologically, clinically and genetically distinct from pure mucinous carcinoma of breast
Peng Sun, Zaixuan Zhong, Qianyi Lu, Mei Li, Xue Chao, Dan Chen, Wenyan Hu, Rongzhen Luo, Jiehua He
Modern Pathology.2020; 33(10): 1945. CrossRef
Micropapillary pattern in pure mucinous carcinoma of the breast – does it matter or not?
Xiaoli Xu, Rui Bi, Ruohong Shui, Baohua Yu, Yufan Cheng, Xiaoyu Tu, Wentao Yang
Histopathology.2019; 74(2): 248. CrossRef
An Update of Mucinous Lesions of the Breast
Beth T. Harrison, Deborah A. Dillon
Surgical Pathology Clinics.2018; 11(1): 61. CrossRef
The clinicopathological significance of micropapillary pattern in colorectal cancers
Jung-Soo Pyo, Mee Ja Park, Dong-Wook Kang
Human Pathology.2018; 77: 159. CrossRef
The sonographic findings of micropapillary pattern in pure mucinous carcinoma of the breast
Heqing Zhang, Li Qiu, Yulan Peng
World Journal of Surgical Oncology.2018;[Epub] CrossRef
Diagnostic dilemma of micropapillary variant of mucinous breast cancer
Geok Hoon Lim, Zhiyan Yan, Mihir Gudi
BMJ Case Reports.2018; : bcr-2018-225775. CrossRef

Detection of Tumor Multifocality Is Important for Prediction of Tumor Recurrence in Papillary Thyroid Microcarcinoma: A Retrospective Study and Meta-Analysis: Jung-Soo Pyo, Jin Hee Sohn, Guhyun Kang; J Pathol Transl Med. 2016;50(4):278-286. Published online June 6, 2016; DOI: https://doi.org/10.4132/jptm.2016.03.29

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Abstract PDF

Background
The clinicopathological characteristics and conclusive treatment modality for multifocal papillary thyroid microcarcinoma (mPTMC) have not been fully established.
Methods
A retrospective study, systematic review, and meta-analysis were conducted to elucidate the clinicopathological significance of mPTMC. We investigated the multiplicity of 383 classical papillary thyroid microcarcinomas (PTMCs) and the clinicopathological significance of incidental mPTMCs. Correlation between tumor recurrence and multifocality in PTMCs was evaluated through a systematic review and meta-analysis.
Results
Tumor multifocality was identified in 103 of 383 PTMCs (26.9%). On linear regression analysis, primary tumor diameter was significantly correlated with tumor number (R²=0.014, p=.021) and supplemental tumor diameter (R²=0.117, p=.023). Of 103 mPTMCs, 61 (59.2%) were non-incidental, with tumor detected on preoperative ultrasonography, and 42 (40.8%) were diagnosed (incidental mPTMCs) on pathological examination. Lymph node metastasis and higher tumor stage were significantly correlated with tumor multifocality. However, there was no difference in nodal metastasis or tumor stage between incidental and non-incidental mPTMCs. On meta-analysis, tumor multifocality was significantly correlated with tumor recurrence in PTMCs (odds ratio, 2.002; 95% confidence interval, 1.475 to 2.719, p<.001).
Conclusions
Our results show that tumor multifocality in PTMC, regardless of manner of detection, is significantly correlated with aggressive tumor behavior.

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Individual risk factors for recurrence after hemithyroidectomy and thyroidectomy in patients with papillary thyroid microcarcinoma in the presence of autoimmune thyroiditis
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Ryuta Nagaoka, Aya Ebina, Kazuhisa Toda, Tomoo Jikuzono, Marie Saitou, Masaomi Sen, Hiroko Kazusaka, Mami Matsui, Keiko Yamada, Hiroki Mitani, Iwao Sugitani
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Endocrine Pathology.2020; 31(4): 377. CrossRef
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Huang, MD Kun, Liu, MD Ji-Bin
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Alka Mary Mathai, K. Preetha, S. Valsala Devi, Sam Vicliph, Raja Pradeep, Aqib Shaick
Indian Journal of Otolaryngology and Head & Neck Surgery.2019; 71(S1): 121. CrossRef
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Isabela de Oliveira Amui, José Vicente Tagliarini, Emanuel C. Castilho, Mariângela de Alencar Marques, Yoshio Kiy, José Eduardo Corrente, Gláucia M.F.S. Mazeto
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Claudio Spinelli, Leonardo Rallo, Riccardo Morganti, Valentina Mazzotti, Alessandro Inserra, Giovanni Cecchetto, Maura Massimino, Paola Collini, Silvia Strambi
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Core Needle Biopsy Is a More Conclusive Follow-up Method Than Repeat Fine Needle Aspiration for Thyroid Nodules with Initially Inconclusive Results: A Systematic Review and Meta-Analysis: Jung-Soo Pyo, Jin Hee Sohn, Guhyun Kang; J Pathol Transl Med. 2016;50(3):217-224. Published online April 14, 2016; DOI: https://doi.org/10.4132/jptm.2016.02.15

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Abstract PDF

Background
This study investigated the appropriate management of thyroid nodules with prior non-diagnostic or atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) through a systematic review and meta-analysis.
Methods
This study included 4,235 thyroid nodules from 26 eligible studies. We investigated the conclusive rate of follow-up core needle biopsy (CNB) or repeat fine needle aspiration (rFNA) after initial fine needle aspiration (FNA) with non-diagnostic or AUS/FLUS results. A diagnostic test accuracy (DTA) review was performed to determine the diagnostic role of the follow-up CNB and to calculate the area under the curve (AUC) on the summary receiver operating characteristic (SROC) curve.
Results
The conclusive rates of follow-up CNB and rFNA after initial FNA were 0.879 (95% confidence interval [CI], 0.801 to 0.929) and 0.684 (95% CI, 0.627 to 0.736), respectively. In comparison of the odds ratios of CNB and rFNA, CNB had more frequent conclusive results than rFNA (odds ratio, 5.707; 95% CI, 2.530 to 12.875). Upon subgroup analysis, follow-up CNB showed a higher conclusive rate than rFNA in both initial non-diagnostic and AUS/FLUS subgroups. In DTA review of followup CNB, the pooled sensitivity and specificity were 0.94 (95% CI, 0.88 to 0.97) and 0.88 (95% CI, 0.84 to 0.91), respectively. The AUC for the SROC curve was 0.981, nearing 1.
Conclusions
Our results show that CNB has a higher conclusive rate than rFNA when the initial FNA produced inconclusive results. Further prospective studies with more detailed criteria are necessary before follow-up CNB can be applied in daily practice.

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MUC2 Expression Is Correlated with Tumor Differentiation and Inhibits Tumor Invasion in Gastric Carcinomas: A Systematic Review and Meta-analysis: Jung-Soo Pyo, Jin Hee Sohn, Guhyun Kang, Dong-Hoon Kim, Kyungeun Kim, In-Gu Do, Dong Hyun Kim; J Pathol Transl Med. 2015;49(3):249-256. Published online May 15, 2015; DOI: https://doi.org/10.4132/jptm.2015.03.27

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Abstract PDF

Background
While MUC2 is expressed in intestinal metaplasia and malignant lesions, the clinico-pathological significance of MUC2 expression is not fully elucidated in gastric carcinoma (GC). Methods: The present study investigated the correlation between MUC2 expression and clinico-pathological parameters in 167 human GCs. In addition, to confirm the clinicopathological significance of MUC2 expression, we performed a systematic review and meta-analysis in 1,832 GCs. Results: MUC2 expression was found in 58 of 167 GCs (34.7%). MUC2-expressing GC showed lower primary tumor (T), regional lymph node (N), and tumor node metastasis (TNM) stages compared with GCs without MUC2 expression (p=.001, p=.001, and p=.011, respectively). However, MUC2 expression was not correlated with Lauren’s classification and tumor differentiation. In meta-analysis, MUC2 expression was significantly correlated with differentiation and lower tumor stage (odds ratio [OR], 1.303; 95% confidence interval [CI], 1.020 to 1.664; p = .034 and OR, 1.352; 95% CI, 1.055 to 1.734; p = .017, respectively) but not with Lauren’s classification, pN stage, or pTNM stage. Conclusions: MUC2 expression was correlated with a lower tumor depth and lower lymph node metastasis in our study; the meta-analysis showed a correlation of MUC2 expression with tumor differentiation and lower tumor depth.

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European Surgical Research.2017; 58(3-4): 158. CrossRef

Case Reports

Extranodal Follicular Dendritic Cell Sarcoma with Rapid Growth in Parapharynx: A Case Report: Jung-Soo Pyo, Guhyun Kang, Sung-Im Do, Seoung Wan Chae, Kyungeun Kim, Sang Hyuk Lee, Yoon-La Choi, Joon Hyuk Choi, Jin Hee Sohn, Dong-Hoon Kim; Korean J Pathol. 2012;46(3):306-310. Published online June 22, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.3.306

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Abstract PDF

Follicular dendritic cell sarcoma (FDCS) is a rare malignancy arising from the antigen-presenting cells in the lymph node and extranodal tissue. We describe a 31-year-old male patient who presented with a swelling of the left parapharynx. The radiologic findings showed a 4.7×4.5×1.9 cm-sized, ill-defined mass in the left parapharyngeal space. A fine-needle aspiration cytology was performed and it showed scattered, irregular, cohesive clusters of tumor cells with a spindle-to-ovoid shape with irregular contours in a background of lymphocytes. Based on these findings, a diagnosis of spindle cell neoplasm was made. The surgically resected tumor was composed of elongated, ovoid or polygonal cells showing positive immunohistochemistry for CD21, CD23, and CD35. Postoperatively, the residual tumor was observed to undergo a rapidly growth. There is an overlap in the cytologic and histologic findings between FDCS of the parapharynx and other tumors. Pathologists should therefore be aware of its characteristics not only to provide an accurate diagnosis but also to recommend the appropriate clinical management.

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Extranodal Follicular Dendritic Cell Sarcoma of the Head and Neck Region: A Clinicopathological Study of 7 Cases
Nasir Ud Din, Zubair Ahmad, Shabina Rahim, Karen Fritchie, Muhammad Usman Tariq, Arsalan Ahmed
International Journal of Surgical Pathology.2023; 31(6): 1067. CrossRef
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
Follicular dendritic cells
Seham A. Abd El‐Aleem, Entesar Ali Saber, Neven M. Aziz, Hani El‐Sherif, Asmaa M. Abdelraof, Laiche Djouhri
Journal of Cellular Physiology.2022; 237(4): 2019. CrossRef
Clinicopathological characteristics of extranodal follicular dendritic cell sarcoma: A report of two cases
Xing Zhao, Dayong Sun, Gang Zhang
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Cytological diagnosis of follicular dendritic cell sarcoma: A case report and review of literature
A. Dutta, P. Arun, P. Roy, I. Arun
Cytopathology.2018; 29(5): 461. CrossRef
Follicular dendritic cells and related sarcoma
Fabio Facchetti, Luisa Lorenzi
Seminars in Diagnostic Pathology.2016; 33(5): 262. CrossRef
Extranodal follicular dendritic cell sarcoma: A clinicopathological report of four cases and a literature review
RUI-FEN WANG, WEI HAN, LEI QI, LI-HUI SHAN, ZHENG-CAI WANG, LI-FENG WANG
Oncology Letters.2015; 9(1): 391. CrossRef
Follicular Dendritic Cell Sarcoma of Parapharyngeal Space: A Case Report and Review of the Literature
Turki Al-Hussain, Muhammad Saleem, Suresh Babu Velagapudi, Mohammad Anas Dababo
Head and Neck Pathology.2015; 9(1): 135. CrossRef
Clinical and pathological features of head and neck follicular dendritic cell sarcoma
Ji Li, Min-Li Zhou, Shui-Hong Zhou
Hematology.2015; 20(10): 571. CrossRef

Metaplastic Thymoma: Report of 4 Cases: Guhyun Kang, Nara Yoon, Joungho Han, Young Eun Kim, Tae Sung Kim, Kwhanmien Kim; Korean J Pathol. 2012;46(1):92-95. Published online February 23, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.1.92

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Abstract PDF

Metaplastic thymoma (MT), accepted in the World Health Organization 2004 scheme, is a circumscribed tumor of the thymus exhibiting biphasic morphology. We herein describe the clinicopathologic features of four MTs and the differential diagnoses of this unusual tumor. There were three women and one man with mean age of 49.5 years. The patients were found to have mediastinal masses, and underwent surgical excision. One exhibited symptoms of myasthenia gravis, and the serum titer for anti-acetylcholine receptor antibody was positive. Grossly, the tumors were encapsulated, and showed vaguely multinodular, solid, tan-white to yellow cut surfaces. Histologically, they comprised epithelial islands intertwining with bundles of delicate spindle cells. The patients remained well after surgical excision at 5-55 months. Because of the distinctive histological appearance and benign clinical course, MT should be distinguished from other more aggressive mediastinal neoplasms displaying biphasic feature.

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