Journal of Pathology and Translational Medicine

Original Articles

Extrapulmonary Lymphangioleiomyoma: Clinicopathological Analysis of 4 Cases: Dae Hyun Song, In Ho Choi, Sang Yun Ha, Kang Min Han, Jae Jun Lee, Min Eui Hong, Yoon-La Choi, Kee-Taek Jang, Sang Yong Song, Chin A Yi, Joungho Han; Korean J Pathol. 2014;48(3):188-192. Published online June 26, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.3.188

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Background

Lymphangioleiomyomatosis (LAM) is a slowly progressive neoplastic disease that predominantly affects females. Usually, LAM affects the lung; it can also affect extrapulmonary sites, such as the mediastinum, the retroperitoneum, or the lymph nodes, although these locations are rare. A localized form of LAM can manifest as extrapulmonary lesions; this form is referred to as extrapulmonary lymphangioleiomyoma (E-LAM). Due to the rare occurrence of E-LAM and its variable, atypical location, E-LAM is often difficult to diagnose. Herein, we report the clinicopathological information from four E-LAM cases, and also review previous articles investigating this disease.

Methods

Four patients with E-LAM were identified at the Samsung Medical Center (Seoul, Korea) from 1995 to 2012. All E-LAM lesions underwent surgical excision.

Results

All patients were females within the age range of 43 to 47 years. Two patients had para-aortic retroperitoneal masses, while the other two patients had pelvic lesions; two out of the four patients also had accompanying pulmonary LAM. In addition, no patient displayed any evidence of tuberous sclerosis. Histologically, two patients exhibited nuclear atypism with cytologic degeneration.

Conclusions

E-LAM should be considered in the differential diagnosis of patients presenting with pelvic or para-aortic masses. We also conclude that further clinical and pathological evaluation is needed in patients with E-LAM and nuclear atypism.

Citations

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Lymphangioleiomyomatosis with Tuberous Sclerosis Complex—A Case Study
Aleksandra Marciniak, Jolanta Nawrocka-Rutkowska, Agnieszka Brodowska, Andrzej Starczewski, Iwona Szydłowska
Journal of Personalized Medicine.2023; 13(11): 1598. CrossRef
A case of lymphangioleiomyomatosis with endometrial cancer diagnosed by retroperitoneoscopic para-aortic lymph node dissection
Aiko Ogasawara, Shogo Yamaguchi, Hiroaki Inui, Mieko Hanaoka, Daisuke Shintani, Sho Sato, Masanori Yasuda, Akira Yabuno
JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY.2022; 38(1): 158. CrossRef
Primary retroperitoneal PEComa: an incidental finding
Bárbara Monteiro Marinho, António Gâmboa Canha, Donzília Sousa Silva, José Davide Pinto Silva
BMJ Case Reports.2022; 15(11): e250466. CrossRef
Imaging Findings of Thoracic Lymphatic Abnormalities
Jingshuo (Derek) Sun, Thomas Shum, Fardad Behzadi, Mark M. Hammer
RadioGraphics.2022; 42(5): 1265. CrossRef
Extrapulmonary uterine lymphangioleiomyomatosis (LAM) and dysfunctional uterine bleeding: the first presentation of LAM in a tuberous sclerosis complex patient
Lucy Grant, Saliya Chipwete, San Soo Hoo, Anjali Bhatnagar
BMJ Case Reports.2019; 12(2): e226358. CrossRef
Summary of the Japanese Respiratory Society statement for the treatment of lung cancer with comorbid interstitial pneumonia
Takashi Ogura, Nagio Takigawa, Keisuke Tomii, Kazuma Kishi, Yoshikazu Inoue, Eiki Ichihara, Sakae Homma, Kazuhisa Takahashi, Hiroaki Akamatsu, Satoshi Ikeda, Naohiko Inase, Tae Iwasawa, Yuichiro Ohe, Hiromitsu Ohta, Hiroshi Onishi, Isamu Okamoto, Kazumasa
Respiratory Investigation.2019; 57(6): 512. CrossRef
Incidental lymphangioleiomyomatosis in the lymph nodes of gynecologic surgical specimens
Ikumi Kuno, Hiroshi Yoshida, Hanako Shimizu, Takashi Uehara, Masaya Uno, Mitsuya Ishikawa, Tomoyasu Kato
European Journal of Obstetrics & Gynecology and Reproductive Biology.2018; 231: 93. CrossRef
Solitary extrapulmonary lymphangioleiomyomatosis of the liver: A case report and literature review
Weiwei Fu, Yujun Li, Hong Li, Ping Yang, Xiaoming Xing
Experimental and Therapeutic Medicine.2016; 12(3): 1499. CrossRef
Incidental Pelvic and Para-aortic Lymph Node Lymphangioleiomyomatosis Detected During Surgical Staging of Pelvic Cancer in Women Without Symptomatic Pulmonary Lymphangioleiomyomatosis or Tuberous Sclerosis Complex
Joseph T. Rabban, Brandie Firetag, Ankur R. Sangoi, Miriam D. Post, Charles J. Zaloudek
American Journal of Surgical Pathology.2015; 39(8): 1015. CrossRef

Usual Interstitial Pneumonia with Lung Cancer: Clinicopathological Analysis of 43 Cases: Dae Hyun Song, In Ho Choi, Sang Yun Ha, Kang Min Han, Jae Jun Lee, Min Eui Hong, Kyeongman Jeon, Man Pyo Chung, Jhingook Kim, Joungho Han; Korean J Pathol. 2014;48(1):10-16. Published online February 25, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.1.10

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Abstract PDF

Background

Previous studies have suggested an association between usual interstitial pneumonia (UIP) and lung cancer (Ca). However, clinical and histological information is not enough to determine such an association, due to the low incidence and short survival time of patients with both conditions.

Methods

We retrospectively reviewed the clinical and histological records of Ca patients with UIP between January 1999 and August 2013 at the Samsung Medical Center, Seoul, Korea. We found 43 patients who had Ca with UIP (UIP-Ca). Previously reported data of eighty-four patients with UIP-only were included as a comparison group.

Results

Smoking is related to poor prognosis in patients with UIP-Ca, and the number of patients with a high smoking index of more than 30 pack-years significantly increased in UIP-Ca patients compared with UIP-only patients. There is no significant prognostic differentiation between UIP-Ca patients and UIP-only patients. Microscopically, UIP-Ca patients showed characteristically heterogeneous histological patterns and degrees of differentiation. There were many foci of squamous metaplasia or dysplasia at the peripheral area of squamous cell carcinomas.

Conclusions

We report 43 cases of UIP-Ca. Our results suggest that smoking is related to cancer occurrence in UIP patients and poor prognosis in UIP-Ca patients.

Citations

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Prognosis of idiopathic pulmonary fibrosis without anti-fibrotic therapy: a systematic review
Yet H. Khor, Yvonne Ng, Hayley Barnes, Nicole S.L. Goh, Christine F. McDonald, Anne E. Holland
European Respiratory Review.2020; 29(157): 190158. CrossRef
Linfoma difuso de células B grandes pulmonar en paciente con neumonía intersticial no específica
Luis Gorospe Sarasúa, Paola Arrieta, Anabelle Chinea-Rodríguez, Carlos de la Puente-Bujidos
Reumatología Clínica.2019; 15(6): e151. CrossRef
Diffuse Large B-cell Lymphoma of the Lung in a Patient With Nonspecific Interstitial Pneumonia
Luis Gorospe Sarasúa, Paola Arrieta, Anabelle Chinea-Rodríguez, Carlos de la Puente-Bujidos
Reumatología Clínica (English Edition).2019; 15(6): e151. CrossRef
Characteristics of lung cancer among patients with idiopathic pulmonary fibrosis and interstitial lung disease – analysis of institutional and population data
Joo Heung Yoon, Mehdi Nouraie, Xiaoping Chen, Richard H Zou, Jacobo Sellares, Kristen L Veraldi, Jared Chiarchiaro, Kathleen Lindell, David O Wilson, Naftali Kaminski, Timothy Burns, Humberto Trejo Bittar, Samuel Yousem, Kevin Gibson, Daniel J Kass
Respiratory Research.2018;[Epub] CrossRef
Genomic profiles of lung cancer associated with idiopathic pulmonary fibrosis
Ji An Hwang, Deokhoon Kim, Sung‐Min Chun, SooHyun Bae, Joon Seon Song, Mi Young Kim, Hyun Jung Koo, Jin Woo Song, Woo Sung Kim, Jae Cheol Lee, Hyeong Ryul Kim, Chang‐Min Choi, Se Jin Jang
The Journal of Pathology.2018; 244(1): 25. CrossRef
Survival after repeated surgery for lung cancer with idiopathic pulmonary fibrosis: a retrospective study
Seijiro Sato, Yuki Shimizu, Tatsuya Goto, Akihiko Kitahara, Terumoto Koike, Hiroyuki Ishikawa, Takehiro Watanabe, Masanori Tsuchida
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Alveolar Squamous Cell Metaplasia: Preneoplastic Lesion?
Adriana Handra-Luca
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Low expression of long noncoding RNA CDKN2B-AS1 in patients with idiopathic pulmonary fibrosis predicts lung cancer by regulating the p53-signaling pathway
Yufeng Du, Xiaoyan Hao, Xuejun Liu
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A clinicopathological study of surgically resected lung cancer in patients with usual interstitial pneumonia
Yasutaka Watanabe, Yoshinori Kawabata, Nobuyuki Koyama, Tomohiko Ikeya, Eishin Hoshi, Noboru Takayanagi, Shinichiro Koyama
Respiratory Medicine.2017; 129: 158. CrossRef
Risk of the preoperative underestimation of tumour size of lung cancer in patients with idiopathic interstitial pneumonias
Mariko Fukui, Kazuya Takamochi, Takeshi Matsunaga, Shiaki Oh, Katsutoshi Ando, Kazuhiro Suzuki, Atsushi Arakawa, Toshimasa Uekusa, Kenji Suzuki
European Journal of Cardio-Thoracic Surgery.2016; 50(3): 428. CrossRef
The Idiopathic Interstitial Pneumonias: Histology and Imaging
Diane C. Strollo, Teri J. Franks, Jeffrey R. Galvin
Seminars in Roentgenology.2015; 50(1): 8. CrossRef
Do Chest Expansion Exercises Aid Re‐shaping the Diaphragm Within the First 72 Hours Following Lung Transplantation in a Usual Interstitial Pneumonia Patient?
Massimiliano Polastri, Erika Venturini, Saverio Pastore, Andrea Dell'Amore
Physiotherapy Research International.2015; 20(3): 191. CrossRef
Scrotal wall metastasis from a primary lung adenocarcinoma
Marie-Louise M. Coussa-Koniski, Pia A. Maalouf, Nehme E. Raad, Noha A. Bejjani
Respiratory Medicine Case Reports.2015; 15: 77. CrossRef
The Ratio KL-6 to SLX in Serum for Prediction of the Occurrence of Drug-Induced Interstitial Lung Disease in Lung Cancer Patients with Idiopathic Interstitial Pneumonias Receiving Chemotherapy
Kosuke Kashiwabara, Hiroshi Semba, Shinji Fujii, Shinsuke Tsumura, Ryota Aoki
Cancer Investigation.2015; 33(10): 516. CrossRef
Idiopathic pulmonary fibrosis will increase the risk of lung cancer
Li Junyao, Yang Ming, Li Ping, Su Zhenzhong, Gao Peng, Zhang Jie
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Cytologic Features of ALK-Positive Pulmonary Adenocarcinoma: Seung Yeon Ha, Jungsuk Ahn, Mee Sook Roh, Joungho Han, Jae Jun Lee, Boin Lee, Jun Yim; Korean J Pathol. 2013;47(3):252-257. Published online June 25, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.3.252

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Abstract PDF

Background

The aim of this study was to determine the cytologic features of anaplastic lymphoma kinase (ALK) expressing pulmonary adenocarcinoma.

Methods

We analyzed the cytopathological findings of 15 cases of endobronchial ultrasound guided aspiration and a case of bronchial washing. These cases were selected based on the histomorphology of ALK-rearranged lung adenocarcinoma.

Results

Cytology showed mucinous (81.3%) and hemorrhagic (50%) backgrounds. The cells were arranged in tubulopapillary or tubulocribriform patterns (93.8%), and clusters (56.3%) admixed with signet ring cell features (87.5%). The tumor cells were monotonous and uniform with vesicular nuclei and a small nucleolus.

Conclusions

The characteristic findings were sheets showing a tubulopapillary or tubulocribriform appearance, with vesicular nuclei and a bland chromatin pattern (p<0.001). Scattered signet ring cells were helpful in suggesting ALK-positive adenocarcinoma (p<0.001).

Citations

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Machine learning‐based gene alteration prediction model for primary lung cancer using cytologic images
Shuhei Ishii, Manabu Takamatsu, Hironori Ninomiya, Kentaro Inamura, Takeshi Horai, Akira Iyoda, Naoko Honma, Rira Hoshi, Yuko Sugiyama, Noriko Yanagitani, Mingyon Mun, Hitoshi Abe, Tetuo Mikami, Kengo Takeuchi
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Fine‐needle aspiration cytology of non‐small cell lung carcinoma: A paradigm shift
Pranab Dey, Ratan Kumar Ghosh
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Qualitative and quantitative cytomorphological features of primary anaplastic lymphoma kinase‐positive lung cancer
Ryuko Tsukamoto, Hiroyuki Ohsaki, Sho Hosokawa, Yasunori Tokuhara, Shingo Kamoshida, Toshiko Sakuma, Tomoo Itoh, Chiho Ohbayashi
Cytopathology.2019; 30(3): 295. CrossRef
Primary signet-ring adenocarcinoma of the lung: A rare lung tumor
Varun Rajpal, Rahul Kumar Sharma, Charul Dabral, Deepak Talwar
South Asian Journal of Cancer.2019; 08(04): 257. CrossRef
Cytological features in eight patients with ALK‐rearranged lung cancer
Naoto Kuroda, Masahiko Ohara, Yukari Wada, Kaori Yasuoka, Keiko Mizuno, Kenji Yorita, Chiho Obayashi, Kengo Takeuchi
Diagnostic Cytopathology.2018; 46(6): 516. CrossRef
Cytological markers for predicting ALK‐positive pulmonary adenocarcinoma
K. Miyata, S. Morita, H. Dejima, N. Seki, N. Matsutani, M. Mieno, F. Kondo, Y. Soejima, F. Tanaka, M. Sawabe
Diagnostic Cytopathology.2017; 45(11): 963. CrossRef
ALK-rearranged adenocarcinoma with extensive mucin production can mimic mucinous adenocarcinoma: clinicopathological analysis and comprehensive histological comparison with KRAS-mutated mucinous adenocarcinoma
Yoon Jin Cha, Joungho Han, Soo Hyun Hwang, Tae Bum Lee, Hojoong Kim, Jea Ill Zo
Pathology.2016; 48(4): 325. CrossRef
Cytomorphological identification of advanced pulmonary adenocarcinoma harboring KRAS mutation in lymph node fine‐needle aspiration specimens: Comparative investigation of adenocarcinoma with KRAS and EGFR mutations
Dae Hyun Song, Boram Lee, Yooju Shin, In Ho Choi, Sang Yun Ha, Jae Jun Lee, Min Eui Hong, Yoon‐La Choi, Joungho Han, Sang‐Won Um
Diagnostic Cytopathology.2015; 43(7): 539. CrossRef
Comprehensive analysis of RET and ROS1 rearrangement in lung adenocarcinoma
Seung Eun Lee, Boram Lee, Mineui Hong, Ji-Young Song, Kyungsoo Jung, Maruja E Lira, Mao Mao, Joungho Han, Jhingook Kim, Yoon-La Choi
Modern Pathology.2015; 28(4): 468. CrossRef

Prognostic Significance of BCL9 Expression in Hepatocellular Carcinoma: Jiyeon Hyeon, Soomin Ahn, Jae Jun Lee, Dae Hyun Song, Cheol-Keun Park; Korean J Pathol. 2013;47(2):130-136. Published online April 24, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.2.130

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Abstract PDF

Background

BCL9 enhances β-catenin-mediated transcriptional activity regardless of the mutational status of the Wnt signaling components and increases the cell proliferation, migration, invasion, and metastatic potential of tumor cells. The goal of this study was to elucidate the prognostic significance of BCL9 protein expression in hepatocellular carcinoma (HCC) patients.

Methods

We evaluated BCL9 protein expression by immunohistochemistry in tumor tissue from 288 primary HCC patients who underwent curative hepatectomy. The impact of BCL9 expression on the survival of the patients was analyzed. The median follow-up period was 97.1 months.

Results

Nuclear BCL9 protein expression was observed in 74 (25.7%) of the 288 HCCs. BCL9 expression was significantly associated with younger age (p=0.038), higher Edmondson grade (p=0.001), microvascular invasion (p=0.013), and intrahepatic metastasis (p=0.017). Based on univariate analyses, BCL9 expression showed an unfavorable influence on both disease-free survival (DFS, p=0.012) and disease-specific survival (DSS, p=0.032). Multivariate analyses revealed that higher Barcelona Clinic Liver Cancer stage was an independent predictor of both shorter DFS (p<0.001) and shorter DSS (p<0.001). BCL9 expression tended to be an independent predictor of shorter DFS (p=0.078).

Conclusions

BCL9 protein expression might be a marker of shorter DFS in HCC patients after curative hepatectomy.

Citations

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Minjie Wu, Heng Dong, Chao Xu, Mengqing Sun, Haojin Gao, Fangtian Bu, Jianxiang Chen
Genes & Diseases.2024; 11(2): 701. CrossRef
The role of BCL9 genetic variation as a biomarker for hepatitis C-related hepatocellular carcinoma in Egyptian patients
Eman Abd El Razek Abbas, Ahmed Barakat Barakat, Mohamed Hassany, Samar Samir Youssef
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Molecular Targets and Signaling Pathways of microRNA-122 in Hepatocellular Carcinoma
Kwang-Hoon Chun
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Wnt/β-Catenin Signalling and Its Cofactor BCL9L Have an Oncogenic Effect in Bladder Cancer Cells
Roland Kotolloshi, Mieczyslaw Gajda, Marc-Oliver Grimm, Daniel Steinbach
International Journal of Molecular Sciences.2022; 23(10): 5319. CrossRef
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Zhuang Wei, Mei Feng, Zhongen Wu, Shuru Shen, Di Zhu
Frontiers in Oncology.2021;[Epub] CrossRef
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Ivana Samaržija
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Myo Win Htun, Yasuaki Shibata, Kyaw Soe, Takehiko Koji
ACTA HISTOCHEMICA ET CYTOCHEMICA.2021; 54(6): 195. CrossRef
Wnt status-dependent oncogenic role of BCL9 and BCL9L in hepatocellular carcinoma
Nicole Huge, Maria Sandbothe, Anna K. Schröder, Amelie Stalke, Marlies Eilers, Vera Schäffer, Brigitte Schlegelberger, Thomas Illig, Beate Vajen, Britta Skawran
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Akshata Moghe, Satdarshan P. Monga
Hepatology International.2020; 14(4): 460. CrossRef
Loss of BCL9/9l suppresses Wnt driven tumourigenesis in models that recapitulate human cancer
David M. Gay, Rachel A. Ridgway, Miryam Müller, Michael C. Hodder, Ann Hedley, William Clark, Joshua D. Leach, Rene Jackstadt, Colin Nixon, David J. Huels, Andrew D. Campbell, Thomas G. Bird, Owen J. Sansom
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Myat Thu Soe, Yasuaki Shibata, Myo Win Htun, Kuniko Abe, Kyaw Soe, Nay Win Than, Thann Lwin, Myat Phone Kyaw, Takehiko Koji
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Jing Wang, Mingjun Zheng, Liancheng Zhu, Lu Deng, Xiao Li, Linging Gao, Caixia Wang, Huimin Wang, Juanjuan Liu, Bei Lin
Cancer Cell International.2019;[Epub] CrossRef
SOX7 Suppresses Wnt Signaling by Disrupting β-Catenin/BCL9 Interaction
Rong Fan, HaiYan He, Wang Yao, YanFeng Zhu, XunJie Zhou, MingTai Gui, Jing Lu, Hao Xi, ZhongLong Deng, Min Fan
DNA and Cell Biology.2018; 37(2): 126. CrossRef
Hypoxia activates Wnt/β-catenin signaling by regulating the expression of BCL9 in human hepatocellular carcinoma
Wei Xu, Wang Zhou, Mo Cheng, Jing Wang, Zhian Liu, Shaohui He, Xiangji Luo, Wending Huang, Tianrui Chen, Wangjun Yan, Jianru Xiao
Scientific Reports.2017;[Epub] CrossRef
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Mohamed Abd El-Fattah
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miR-30a acts as a tumor suppressor by double-targeting COX-2 and BCL9 in H. pylori gastric cancer models
Xuan Liu, Qing Ji, Chengcheng Zhang, Xiaowei Liu, Yanna Liu, Ningning Liu, Hua Sui, Lihong Zhou, Songpo Wang, Qi Li
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BCL9, a coactivator for Wnt/β-catenin transcription, is targeted by miR-30c and is associated with prostate cancer progression
XIAO-HUI LING, ZHI-YUN CHEN, HONG-WEI LUO, ZE-ZHEN LIU, YING-KE LIANG, GUAN-XING CHEN, FU-NENG JIANG, WEI-DE ZHONG
Oncology Letters.2016; 11(3): 2001. CrossRef

Methylation and Immunoexpression of p16^INK4a Tumor Suppressor Gene in Primary Breast Cancer Tissue and Their Quantitative p16^INK4a Hypermethylation in Plasma by Real-Time PCR: Jae Jun Lee, Eunkyung Ko, Junhun Cho, Ha Young Park, Jeong Eon Lee, Seok Jin Nam, Duk-Hwan Kim, Eun Yoon Cho; Korean J Pathol. 2012;46(6):554-561. Published online December 26, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.6.554

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Abstract PDF

Background

The p16^INK4a gene methylation has been reported to be a major tumorigenic mechanism.

Methods

We evaluated the methylation status of the p16^INK4a genes in 231 invasive breast cancer and 90 intraductal carcinoma specimens using a methylation-specific polymerase chain reaction and p16 protein expression using immunohistochemistry. The quantity of cell-free methylated p16^INK4a DNA in the plasma samples of 200 patients with invasive breast cancer was also examined using a fluorescence-based real-time polymerase chain reaction assay.

Results

The frequencies of p16^INK4a methylation in invasive and intraductal tumors were 52.8% (122/231) and 57.8% (52/90), respectively. The p16 protein was overexpressed in 145 of the 231 invasive carcinomas (62.8%) and 63 of the 90 intraductal carcinomas (70%). High p16 expression in invasive carcinomas correlated significantly with a high histologic grade, a negative estrogen receptor and progesterone receptor status, p53 immunoreactivity and high Ki-67 expression with immunohistochemistry. In addition, the methylation index of p16^INK4a was significantly higher in the cancer patients than the normal controls (p<0.001).

Conclusions

High p16 immunoreactivity correlated with a loss of differentiation in breast carcinomas and high frequency of p16^INK4a promoter methylation in both invasive and intraductal carcinomas, suggesting it may be involved in the pathogenesis of breast cancer.

Citations

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Sheetal Chauhan, Seema Sen, Anjana Sharma, Seema Kashyap, Radhika Tandon, Mandeep S Bajaj, Neelam Pushker, Murugesan Vanathi, Shyam S Chauhan
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Kevin C Knower, Sarah Q To, Yuet-Kin Leung, Shuk-Mei Ho, Colin D Clyne
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Oncology Reports.2013; 30(6): 2969. CrossRef

Clinicopathological Analysis of 21 Thymic Neuroendocrine Tumors: Soomin Ahn, Jae Jun Lee, Sang Yun Ha, Chang Ohk Sung, Jhingook Kim, Joungho Han; Korean J Pathol. 2012;46(3):221-225. Published online June 22, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.3.221

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Abstract PDF

Background

Thymic neuroendocrine carcinomas (NECs) are uncommon, for which there is no established information available because of a limited number of epidemiological study in Asia.

Methods

We reviewed 21 cases of surgically resected thymic NECs, and evaluated their pathological and clinical features.

Results

It showed male predominance (male/female ratio, 15/6) with wide age range from 20 to 72 years (mean age, 49 years). All 21 cases were divided into two types according to the World Health Organization criteria: atypical carcinoid (n=18) and large cell NEC (n=3). Three cases of atypical carcinoid (AC) were associated with ectopic Cushing's syndrome. All the patients (3/3) with large cell NEC (3/3) and 16.7% (3/18) of those with AC died of tumor progression. Common sites of metastasis included lung, lymph node, brain, lumbar spine, mediastinum, bone, and liver.

Conclusions

In conclusion, thymic neuroendocrine tumors carry a poor prognosis. Regarding the tumor classification, our results showed that a vast majority of carcinoids in the thymus correspond to ACs. In addition, our results also indicate that typical carcinoid is a very rare entity. Some cases of AC exhibited a large size, solid pattern and they showed aggressive clinical behavior, which highlights the spectrum of histologic appearances of thymic NECs.

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Case Report

Localized Primary Thymic Amyloidosis Presenting as a Mediastinal Mass: A Case Report.: Sang Yun Ha, Jae Jun Lee, Heejung Park, Joungho Han, Hong Kwan Kim, Kyung Soo Lee; Korean J Pathol. 2011;45:S41-S44.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.S1.S41

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Abstract PDF

We herein describe a case of a 55-year-old healthy woman with localized primary thymic amyloidosis presented as a mediastinal mass, found incidentally by chest radiography. Computed tomography revealed a 4.1 cm soft tissue lesion with nodular calcification in the left anterior mediastinum. The resected specimen was a well-defined lobulating mass with calcification. Microscopically, the mass was consisted of amorphous eosinophilc hyalinized substances involving the thymus and intrathymic lymph nodes. These eosinophilic substances showed apple-green bi-refringence under polarized light after staining with Congo red. In immunohistochemical study, they were positive for kappa and lambda light chains and negative for amyloid A. There was no evidence of systemic amyloidosis in clinical investigations. A final diagnosis of localized primary thymic amyloidosis was made.

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Original Article

Mucoepidermoid Carcinoma of Tracheobronchial Tree: Clinicopathological Study of 31 Cases.: Sang Yun Ha, Joungho Han, Jae Jun Lee, Young Eun Kim, Yoon La Choi, Hong Kwan Kim; Korean J Pathol. 2011;45(2):175-181.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.2.175

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Abstract PDF

BACKGROUND
All aspects of mucoepidermoid carcinoma (MEC) of the lung including histologic grading, clinical behavior and its differentiation from adenosquamous cell carcinoma are still not fully understood.
METHODS
We reviewed the hematoxylin-eosin stained slides and medical records of 31 cases of MEC of the lungs. The cases were classified as low and high grade according to the quantitative grading system formulated for MEC. High grade tumors were tested for an epidermal growth factor receptor (EGFR) mutation.
RESULTS
Twenty eight cases were classified as low grade and 3 cases as high grade. Histologically, lower glandular component, cellular atypia, necrosis, mitoses >4/10 high power fields, and endolymphatic tumor emboli were typical characteristics of a high grade tumor. Although some tumors showed histologic features mimicking high grade tumors, they were classified as low grade tumors according to this quantitative grading system. Low grade tumors showed no recurrence or metastasis. However, among three patients with a high grade tumor, two had distant metastases and one died of disease. Additionally, an EGFR mutation was not detected.
CONCLUSIONS
A high grade MEC was consistently different from a low grade tumor with regard to malignant histologic features and poor prognosis. Therefore, correct histologic grading is important in predicting the prognosis to avoid unnecessary treatment.

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