Journal of Pathology and Translational Medicine

Original Article

Characteristics of Cutaneous Lymphomas in Korea According to the New WHO-EORTC Classification: Report of a Nationwide Study: Jae Ho Han, Young-Hyeh Ko, Yun Kyung Kang, Wan-Seop Kim, Yoon Jung Kim, Insun Kim, Hyun-Jung Kim, Soo Kee Min, Chan-Kum Park, Chan-Sik Park, Bong-Kyung Shin, Woo Ick Yang, Young-Ha Oh, Jong Sil Lee, Juhie Lee, Tae Hui Lee, Hyekyung Lee, Ho Jung Lee, Yoon Kyung Jeon, Hee Jeong Cha, Yoo-Duk Choi, Chul Woo Kim; Korean J Pathol. 2014;48(2):126-132. Published online April 28, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.2.126

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Background

Previously, cutaneous lymphomas were classified according to either the European Organization for the Research and Treatment of Cancer (EORTC) or the World Health Organization (WHO) classification paradigms. The aim of this study was to determine the relative frequency of Korean cutaneous lymphoma according to the new WHO-EORTC classification system.

Methods

A total of 517 patients were recruited during a recent 5 year-period (2006-2010) from 21 institutes and classified according to the WHO-EORTC criteria.

Results

The patients included 298 males and 219 females, and the mean age at diagnosis was 49 years. The lesions preferentially affected the trunk area (40.2%). The most frequent subtypes in order of decreasing prevalence were mycosis fungoides (22.2%), peripheral T-cell lymphoma (17.2%), CD30+ T-cell lymphoproliferative disorder (13.7%), and extranodal natural killer/T (NK/T) cell lymphoma, nasal type (12.0%). Diffuse large B-cell lymphoma accounted for 11.2% of cases, half of which were secondary cutaneous involvement; other types of B-cell lymphoma accounted for less than 1% of cases.

Conclusions

In comparison with data from Western countries, this study revealed relatively lower rates of mycosis fungoides and B-cell lymphoma in Korean patients, as well as higher rates of subcutaneous panniculitis-like T-cell lymphoma and NK/T cell lymphoma.

Citations

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The First Case of Acute Myeloid Leukemia With t(10;11)(p13;q21);PICALM-MLLT10 Rearrangement Presenting With Extensive Skin Involvement
Min-Seung Park, Hyun-Young Kim, Jae Joon Lee, Duck Cho, Chul Won Jung, Hee-Jin Kim, Sun-Hee Kim
Annals of Laboratory Medicine.2023; 43(3): 310. CrossRef
Recent advances on cutaneous lymphoma epidemiology
G. Dobos, M. Miladi, L. Michel, C. Ram-Wolff, M. Battistella, M. Bagot, A. de Masson
La Presse Médicale.2022; 51(1): 104108. CrossRef
Specific cutaneous infiltrates in patients with haematological neoplasms: a retrospective study with 49 patients
Rebeca Calado, Maria Relvas, Francisca Morgado, José Carlos Cardoso, Oscar Tellechea
Australasian Journal of Dermatology.2021;[Epub] CrossRef
Epidemiology of Cutaneous T-Cell Lymphomas: A Systematic Review and Meta-Analysis of 16,953 Patients
Gabor Dobos, Anne Pohrt, Caroline Ram-Wolff, Céleste Lebbé, Jean-David Bouaziz, Maxime Battistella, Martine Bagot, Adèle de Masson
Cancers.2020; 12(10): 2921. CrossRef
Primary cutaneous lymphoma in Argentina: a report of a nationwide study of 416 patients
Alejandra Abeldaño, Paula Enz, Matias Maskin, Andrea B. Cervini, Natallia Torres, Ana C. Acosta, Marina Narbaitz, Silvia Vanzulli, Mirta Orentrajch, Marta A. Villareal, Maria L. Garcia Pazos, Mariana Arias, Evelyn A. Zambrano Franco, Maria I. Fontana, Rob
International Journal of Dermatology.2019; 58(4): 449. CrossRef
Post-thymic CD4 positive cytotoxic T cell infiltrates of the skin: A clinical and histomorphologic spectrum of the unique CD4 positive T cell of immunosenescence
Cynthia M. Magro, Luke C. Olson, Shabnam Momtahen
Annals of Diagnostic Pathology.2019; 38: 99. CrossRef
Cutaneous lymphomas in Taiwan: A review of 118 cases from a medical center in southern Taiwan
Chaw-Ning Lee, Chao-Kai Hsu, Kung-Chao Chang, Cheng-Lin Wu, Tsai-Yun Chen, Julia Yu-Yun Lee
Dermatologica Sinica.2018; 36(1): 16. CrossRef
Imaging analysis of superficial soft tissue lymphomas
In Sook Lee, You Seon Song, Seung Hyun Lee, Young Jin Choi, Sung Moon Lee
Clinical Imaging.2018; 49: 111. CrossRef
Epidemiologic, clinical and demographic features of primary cutaneous lymphomas in Castilla‐La Mancha, Spain: are we different?
C. Ramos‐Rodríguez, M. García‐Rojo, G. Romero‐Aguilera, M. García‐Arpa, L. González‐López, M.P. Sánchez‐Caminero, J. González‐García, M. Delgado‐Portela, M.P. Cortina‐De La Calle, M.F. Relea‐Calatayud, F. Martín‐Dávila, R. López‐Pérez, M. Ramos‐Rodríguez
Journal of the European Academy of Dermatology and Venereology.2018;[Epub] CrossRef
Nasal-type NK/T-cell lymphomas are more frequently T rather than NK lineage based on T-cell receptor gene, RNA, and protein studies: lineage does not predict clinical behavior
Mineui Hong, Taehee Lee, So Young Kang, Suk-Jin Kim, Wonseog Kim, Young-Hyeh Ko
Modern Pathology.2016; 29(5): 430. CrossRef
Cutaneous lymphoma: Kids are not just little people
Katalin Ferenczi, Hanspaul S. Makkar
Clinics in Dermatology.2016; 34(6): 749. CrossRef

Case Study

Spindle Cell Rhabdomyosacoma of Uterus: A Case Study: Dae Woon Kim, Jung Hwan Shin, Ho Jung Lee, Young Ok Hong, Jong Eun Joo, Eun Kyung Kim; Korean J Pathol. 2013;47(4):388-391. Published online August 26, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.4.388

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Abstract PDF

Uterine rhabdomyosarcoma (RMS) typically presents as a mixed epithelial and mesenchymal tumors. Pure RMSs of the female genital tract are uncommon. Spindle cell variant of RMS is a rare morphologic subtype of embryonal RMS and mostly occurs in the paratesticular region of children. Here, we present a case of uterine spindle cell RMS in a 76-year-old woman. The tumor, 20×15×7 cm in size, was highly necrotic and adherent to the colon and rectum. Tumor cells were mostly spindle-shaped, and isolated rhabdomyoblasts were scattered. Immunohistochemical stains for myoglobin and myo-D1 showed diffuse positivity for tumor cells. The patient died only of disease three months after diagnosis.

Citations

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Embryonal rhabdomyosarcoma of the uterine corpus: a clinicopathological and molecular analysis of 21 cases highlighting a frequent association with DICER1 mutations
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Modern Pathology.2021; 34(9): 1750. CrossRef
Vaginal embryonal rhabdomyosarcoma in young woman: A case report and literature review
Lalya Issam, Laatitioui Sana, Essadi Ismail, El Omrani Abdelhamid, Khouchani Mouna
Archives of Cancer Science and Therapy.2020; 4(1): 034. CrossRef
Is fertility-preservation safe for adult non-metastatic gynecologic rhabdomyosarcoma patients? Systematic review and pooled survival analysis of 137 patients
Maha AT Elsebaie, Zeinab Elsayed
Archives of Gynecology and Obstetrics.2018; 297(3): 559. CrossRef
Spindle cell sarcoma – a rare diagnosis
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Malignant mesenchymal tumors of the uterus – time to advocate a genetic classification
Birgit Rommel, Carsten Holzmann, Jörn Bullerdiek
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Human rhabdomyosarcoma cells express functional pituitary and gonadal sex hormone receptors: Therapeutic implications
AGATA PONIEWIERSKA-BARAN, GABRIELA SCHNEIDER, WENYUE SUN, AHMED ABDELBASET-ISMAIL, FREDERIC G. BARR, MARIUSZ Z. RATAJCZAK
International Journal of Oncology.2016; 48(5): 1815. CrossRef
Primary third ventricular tumor in an 18‐year‐old man
Tianping Yu, Mengni Zhang, Qiao Zhou, Jing Gong, Ling Nie, Xueqin Chen, Ni Chen
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Rhabdomyosarcoma of vulva in a young lady
Tapesh Bhattacharyya, Firuza D. Patel, Radhika Srinivasan, Bhavana Rai, Pradeep Saha, R. Nijhawan
Journal of Cancer Research and Therapeutics.2015; 11(3): 650. CrossRef
Uterine sarcoma in a 14year-old girl presenting with uterine rupture
Jane Özcan, Özlem Dülger, Latif Küpelioğlu, Ali İhsan Gönenç, Aynur Erşahin
Gynecologic Oncology Reports.2014; 10: 44. CrossRef

Case Reports

Enterobius vermicularis Ova in a Vaginal Smear.: Seung Kyu Choi, Eun Kyung Kim, Young Ok Hong, Ho Jung Lee, Won Mi Lee, Sook Kyung Ko, Jong Eun Joo; Korean J Pathol. 2010;44(3):341-342.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.3.341

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Abstract PDF

Enterobius vermicularis is one of the most common parasites found in the intestine of humans. The gravid female worms migrate outside the anus to release eggs on the perianal skin. Rarely, they migrate to the genitourinary tract in female patients. We present a case in which pinworm eggs were found in a cervicovaginal smear of a 37-year-old woman. The eggs were elongated oval shaped and flattened on one side. The thick, double contoured birefringent shell stained bright yellow or orange. Some coarsely granular embryos or curved larvae were enclosed in the refractile shell. Empty eggs or wrinkled shells with clumped granular material were also present. Although pinworm eggs are easily identified because of their characteristic morphologic appearance, careful screening is needed due to the frequent masking by inflammatory cells.

Citations

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Enterobius vermicularis larvae in urine sample of female student: The first case report in Indonesia
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Vaginal Enterobius vermicularis diagnosed on liquid‐based cytology during Papanicolaou test cervical cancer screening: A report of two cases and a review of the literature
Chun‐Yi Tsai, Rachel Junod, Martine Jacot‐Guillarmod, Charles Beniere, Sonia Ziadi, Massimo Bongiovanni
Diagnostic Cytopathology.2018; 46(2): 179. CrossRef
Recurrent paediatric pinworm infection of the vagina as a potential reservoir for Enterobius vermicularis
B. Kashyap, J.C. Samantray, S. Kumar, R. Jhamb, A.K. Singh, I.R. Kaur
Journal of Helminthology.2014; 88(3): 381. CrossRef

Giant Cell Myocarditis: A case report.: Ho Jung Lee, Jae Gul Chung, In Chul Lee, Myeong Gun Song, Jae Jung Kim, Jong Goo Lee; Korean J Pathol. 1996;30(6):523-527.

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Abstract PDF: Giant cell myocarditis(GCM) is a rare inflammatory heart disease which is characterized by multinucleated giant cells and a granulomatous reaction. It usually progresses rapidly and results in a fatal course. We report a patient with giant cell myocarditis who was treated by cardiac transplantation. A 35-year-old male was admitted with dyspnea which had developed 4 months before. On echocardiography, the right and left ventricles were markedly dilated and severe global hypokinesia was noted. He was diagosed with dilated cardiomyopathy with secondary severe mitral regurgitation. His cardiac function deteriorated progressively. He underwent orthotopic heart transplantation. Grossly the heart was enlarged, weighing 420gm and round with a blunt apex. Both right and left ventricles were markedly dilated. There were numerous white patches, measuring up to 4cm, throughout the epi- and myocardium. Microscopically, extensive fibrosis and multiple exuberant granulomas with numerous scattered multinucleated giant cells were seen. Lymphocytes and eosinophils were also frequent. Coronary arteries were unremarkable. Neither microorganisms nor foreign materials were found. By serial endomyocardial biopsies of the transplanted heart, only mild perivascular lymphocytic infiltration was occasionally observed without any evidence of rejection or recurrence of giant cell myocarditis. The patient's postoperative course has been uneventful so far(postoperative 21 months). The etiology of GCM remains to be clarified, although various factors are suspected. No matter what the cause, our experience suggests that this grave disease might be treated well by heart transplantation.

Cardiac Fibroma: A surgically excised case.: Ho Jung Lee, Gyung Ub Gong, Jay Won Lee, Jae Gon Go, In Chul Lee; Korean J Pathol. 1996;30(6):544-547.

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Abstract PDF: Primary cardiac tumors in infancy and childhood are rare, with fibromas being the second most common tumor after rhabdomyomas. Although cardiac fibromas are characteristically benign intramural tumors, they may exhibit exhibit expansile growth resulting in obstruction, valvular dysfunction, as well as other problems so early diagnosis and successful surgical excision are important. We report a case of cardiac fibroma in a 2 month-old male infant. He presented with generalized cyanosis from birth. Echocardiography showed oval round large mass filing the right atrium and ventricle which infiltrated into the lateral wall of the ventricle. Partial excision of the tumor was done after another echocardiogram showed a pericardial effusion and restriction of blood flow to the right ventricle due to the tumor. The resected tumor was ovoid, gray-tan, slightly firm and measuring 5x3x2.5 cm. Histologically, the tumor was composed of spindle-shaped fibroblasts and hyalinized fibrous tissue interdigitating with the surrounding myocardium.

Original Articles

Histopathologic Analysis of Helicobacter Pylori Associated Gastritis.: Ho Jung Lee, Eun Sil Yu, In Chul Lee; Korean J Pathol. 1996;30(9):764-774.

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Abstract PDF: Gastric mucosa shows continuous changes in surface epithelium as well as inflammatory reaction by various substances from the outside and their metabolic products. Gastric mucosal lesions are proven to be associated with bacterial infection by the discovery of Heliobacter pylori(H. pylori) and many studies about histopathologic changes of gastric mucosa associated H. pylori infection has been advanced. It is known that H. pylori associated gastritis displays surface foveolar epithelial changes, such as cytoplasmic vacuolation, mucin loss, juxtaluminal cytoplasm erosion, epithelial denudation, and mucosal irregularity. There have been many studies that H. pylori infection is associated with intestinal metaplasia, gastric dysplasia, and carcinoma. Also chronic H. pylori infection with its induction of gastric lymphoid follicle has been implicated as a precursor of gastric lymphoma of the unique B-cell type that arises from mucosa-associated lymphoid tissue(MALT). However, these gastric mucosal changes are also observed in gastritis with other causes. In this study, we aimed to define specific histopathiologic findings associated with H. pylori infection. A total of 463 gastric biopsy specimens were reviewed. They were Helicobacter-associated gastritis and were divided as many (MH), a few (AH), and no (NH), according to the number of H. pylori. 210 (MH), 131 (AH), and 122 (NH) biopsy specimens were included. Lymphocytes, plasma cells in lamina propria, eosinophils and neutrophils in surface epithelium and crypt as well as lamina propria were graded from 0 to 3. Surface epithelial changes including cytoplasmic vacuolation, mucin loss, juxtaluminal erosion, epithelial denudation and mucosal irregrarity were observed in 200 of 210 cases(95%) in MH group, 34 of 131 cases(26%) in AH group, and 6 of 122 cases(5%) in NH group. This result indicates there is significant difference in surface epithelial changes according to the number of H. pylori(p<0.001). Severity of eosinophil, neutrophil, lymphocyte, and plasma cell infiltration is increased in proportion to the number of H. pylori. Especially, neutrophilic infiltration is not identified in 95 of 122 cases(78%) in NH group, whereas MH group shows severe infitration (grade 3) in 127 of 210 cases(61%), and no (grade 0) in 11 of 210 cases(5%). This data well explains that the severity of neutrophil infiltration is associated with, the degree of H. pylori infection in chronic active gastritis, with statistical significance. The prevalence of lymphoid follicle formation was 17 of 120 cases(14%) in NH group, 24 of 131 cases(18%) in AH group, and 52 of 210 cases(25%) in MH group. This shows that lymphoid follicle formation correlates with the number of H. pylori, but without statistical significance. The prevalence of intestinal metaplasia in NH, AH, and MH was 43 of 122 cases(35%), 46 of 131 cases(35%), and 69 of 210 cases(33%), showing no association between intestinal metaplasia and H. pylori. In summary, H. pylori associated gastritis dispays characteristic histopathological changes in gastric mucosa, in which surface epithelial changes and various inflammatory infiltrates are increased in proportion to the number of H. pylori. Especially vacuolization of surface foveolar epithelium, cryptitis, and crypt abscess are specific findings of H. pylori associated gastritis.

Cytologic and Histologic Correlation for Quality Assurance in Aspiration Cytology.: Ho Jung Lee, Young Mee Cho, So Young Park, Joo ryung Huh, On Ja Kim, Gyung Yub Gong; Korean J Pathol. 1997;31(11):1214-1221.

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Abstract: For quality assurance purposes, the authors correlated aspiration cytology and subsequent tissue findings and examined the reasons for discrepancies. In three months from Jan. to Mar. 1996, 1,383 aspirations were performed, of which 285 (20.6%) had subsequent tissue diagnoses within two months. The aspiration sites were thyroid (483), lymph node (LN) (290), breast (250), soft tissue (154), liver (89), lung (49), salivary gland (26), pancreas (22), gallbladder (3), bone (3), joint (2), adrenal gland (2), scrotum (2), mediastinum (2), omentum (2), oral cavity (1), chest wall (1), and intraabdominal (1) and pelvic cavities (1). A total of 68 discrepancies were identified, and biopsies and smears from these cases were reviewed monthly. In 27 cases (40%), the discrepancy was attributed to sampling error. In five cases (9%), aspiration gave superior results with better sampling and preservation than biopsy. Thirty six cases (53% of discrepant cases) were errors in cytologic diagnosis. We categorized these discrepancies into "A", "B", and "C" ("A": minor disagreement with no affect on patient care, "B": minimal affect on patient care, "C": major affect on patient care), which were 9 (13%), 14 (21%) and 13 (19%) cases, respectively. In thirteen cases of category "C", there were eleven false negative and two false positive diagnoses. Eleven false negative cases included thyroid (3), lymph node (2), breast (2), bone (1), salivary gland (1), lung (1), and liver (1). Three cases of thyroid were papillary carcinomas diagnosed as nodular hyperplasia (1), occasional pleomorphic cells (1), and cystic change (1). Two breast cases of invasive ductal carcinomas were diagnosed as ductal hyperplasia. A malignant lymphoma was diagnosed as reactive hyperplasia and a metastatic carcinoma of LN was diagnosed as tuberculosis. Other cases were malignant tumors of bone, salivary gland, lung, and liver those were misinterpreted as benign lesion or normal. Of two false positive cases, one was nodular hyperplasia of thyroid diagnosed as papillary carcinoma and the other was normal islet cell of pancreas diagnosed as islet cell tumor. A continuous monitoring of laboratory performance is an essential component of the quality control and assurance, and the review of discrepant cases provides useful information for improvement of diagnosis.

Fine Needle Aspiration Cytology of Intraoral Lesions .: Ho Jung Lee, Gyungyub Gong, Dong Hae Chung, Jooryung Huh, On Ja Kim; Korean J Cytopathol. 1998;9(2):155-160.

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Abstract PDF: Fine needle aspiration cytology(FNAC) has become a popular method for the diagnosis of a wide variety of both superficial and deep-seated lesions. However, there are few reports about the potential of FNAC for the diagnosis of intraoral lesions. We experienced 44 FNACs from intraoral lesions at Asan Medical Center: 22 from the palate, 6 from the tongue, 5 from the parapharyngeal space, 5 from the lip, 2 from the floor of mouth, 1 from the buccal mucosa, and 3 from other intraoral sites. Histological confirmation was obtained in 32 cases and we analyzed 27 cases excluding 5 cases of inadequate aspirates. Diagnosis was specifically made in 19 of 27 cases(70%) including 1 mucoepidermoid carcinoma, 1 undifferentiated carcinoma, 1 chordoma, 9 pleomorphic adenomas, 1 neurofibroma, and 6 benign lesions. There were three false negative cases(sensitivity, 62.5%) and no false positive cases(specificity, 100%): Two cases diagnosed as "cystic lesion" were confirmed to be mucoepidermoid carcinomas and a case diagnosed as pleomorphic adenoma was proved to be adenoid cystic carcinoma. The results of our study suggest that FNAC is a useful technique in the diagnosis of intraoral lesion.

A Cytomorphologic Study of Benign and Malignant Papillary Neoplasms of the Breast.: Ho Jung Lee, Gyungyub Gong, Bohng Hee Kim, Sei Hyun Ahn, Jeong Mi Park, Jooryung Huh, Shin Kwang Khang, Jae Y Ro; Korean J Cytopathol. 1999;10(1):27-34.

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Abstract PDF: Benign and malignant papillary neoplasms of the breast may be difficult to distinguish in both cytologic and histologic preparations. To define the cytologic features of benign and malignant papillary lesions, we retrospectively reviewed 18 cases of fine needle aspirates from histologically confirmed cases of papilloma or papillary carcinoma of the breast. This study included 3 intraductal papillary carci nomas, 3 invasive papillary carcinomas, and 12 intraductal papillomas. All cases were evaluated for presence or absence of papillary fragments, bloody background, apocrine metaplasia, macrophages, and degree of cellularity, atypia, and single isolated columnar epithelial cells. Papillary fragments were present in all cases. The background of the smear was bloody in all 6 carcinomas, but in only 7 out of 12 papillomas. Markedly increased cellularity was present in 4 carcinomas(67%) and 7 papillomas(58%). Single cells were present in 5 carcinomas(83%) and 8 papil lomas(67%). The majority of papillomas and papillary carcinomas had mild to moderate atypia, and severe atypia was noted in one case of intraductal papillary carcinoma and one case of invasive papillary carcinoma. Apocrine metaplasia was absent in all cases of papillary carcinomas, but present in 8 papillomas(67%). Macrophages were noted in 4 carcinomas and were present in all cases of papillomas. The constellation of severe atypia, bloody background, absence of apocrine metaplasia and/or macrophages were features to favor carcinoma. Malignant lesions tended to show higher cellularity and more single isolated cells. The cytologic features mentioned above would be helpful to distinguish benign from malignant papillary lesions of the breast. However, because of overlapping of cytologic features, surgical excision should be warranted in all cases of papillary lesions of the breast to further characterize the tumor.

Case Report

Submandibular Soft Tissue Actinomycosis Diagnosed by Fine Needle Aspiration Cytology: A Case Report.: Ho Jung Lee, Dong Hoon Kim, Won Mi Lee, Eun Kyung Kim, Jong Eun Joo; Korean J Cytopathol. 2005;16(1):57-60.

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Abstract PDF: A patient with actinomyces infection of the submandibular soft tissue was diagnosed by fine needle aspiration cytology (FNAC). A 38-year-old woman presented with a right submandibular mass which slowly grew in size over one month. Clinically and radiologically, the lesion was considered as tuberculous lymphadenitis or cellulitis. The polymerase chain reaction for tuberculosis was done by aspirated specimen but the result was negative. The smears of aspiration cytology showed characteristic colonies(sulfur granules) of actinomyces in inflammatory background. After antibiotic therapy for eight months, the patient has been well, showing no detectable mass. This patient was simply and rapidly diagnosed by FNAC and can avoid unnecessary surgical biopsy.

Original Article

Expression of p34(cdc2), p27(Kip1), p21(WAF1/Cip1) and p53 in Human Breast Cancers.: Dong Hoon Kim, Chan Kum Park, Ho Jung Lee, Won Mi Lee, Eun Kyung Kim, Jong Eun Joo; Korean J Pathol. 2005;39(6):391-400.

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Abstract PDF: BACKGROUND
Cell cycle progression is governed by cell cycle regulators and inhibitors such as the cyclin dependent kinases (CDK), p27(Kip1), p21(WAF1/Cip1) and p53. The purpose of this study was to correlate expressions of p34(cdc2), p27(Kip1), p21(WAF1/Cip1) and p53 with the various clinicopathologic prognostic parameters of human breast cancers.
METHODS
The paraffin-embedded tissue sections from 102 patients with human breast carcinomas were examined by performing immunohistochemical staining. The primary antibodies used for immunohistochemical staining were mouse monoclonal antibody to human p34(cdc2), p27(Kip1), p21(WAF1/Cip1), p53, ER and PR.
RESULTS
The expression rates of p34(cdc2), p21(WAF1/Cip1) and p53 were 29.3%, 40.2% and 49.1% in breast carcinomas, respectively. In normal breast tissues, p34(cdc2), p21(WAF1/Cip1) and p53 were not expressed. The p34(cdc2) was expressed in the cytoplasm of cancer cells. The expression rate of p27(Kip1) was 29.3% in breast carcinomas and 100% in normal breast tissues, so the loss of p27(Kip1) expression in breast cancer was noted. The high expression of p21(WAF1/Cip1) in neoplastic cells was associated with the p53 expression (p=0.03). The expression of p27(Kip1) was correlated with that of the progesterone receptor (PR) (p=0.04) and the expression of p21(WAF1/Cip1) was correlated with that of positivity for estrogen receptor (ER) (p=0.04) and PR (p=0.04). No correlation was demonstrated between the mean patient survival and the expression rate of p34(cdc2), p27(Kip1), p21(WAF1/Cip1) and p53.
CONCLUSIONS
The loss of the normal cell growth cycle by the abnormal expression of cyclin dependent kinases and their inhibitors and the steroid hormones may play an important role in human breast carcinogenesis. The p53 dependent p21(WAF1/Cip1) pathway, the p27(Kip1) protein loss and the cdc2 overexpression were important in development and progression of human breast cancer.

Case Report

Localized Amyloidosis of the Ureter: A Report of Two Cases.: Ho Jung Lee, Dong Eun Song, Jong Eun Joo, Won Mi Lee, Dong Hoon Kim, Eun Kyung Kim, Jae Y Ro; Korean J Pathol. 2004;38(3):184-187.

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Abstract PDF: We report on two cases of localized amyloidosis involving the ureter. The patients were a 64-year-old woman with right upper quadrant pain (case 1) and a 36-year-old woman suffering from left flank pain and intermittent gross hematuria (case 2). An intravenous pyelography of case 1 revealed multiple filling defects in the entire right ureter, whereas retrograde pyelography in case 2 showed diffuse narrowing in the mid and lower portions of the left ureter. Localized amyloidosis of the ureter was diagnosed in the two cases, and both had amyloid deposit in the renal pelvis and the urinary bladder in case 1, and in the contralateral ureter and the renal pelvis in case 2. Right nephroureterectomy was performed in case 1, but a segmental resection of the ureter with preservation of the kidney was administered in case 2. These two cases demonstrate that ureteral amyloidosis can be associated with amyloid deposition in the renal pelvis and the urinary bladder. Although ureteral amyloidosis is a rare occurrence, it should be considered in the differential diagnosis of ureteral obstruction to avoid unnecessary radical surgery.

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