Journal of Pathology and Translational Medicine

Original Article

Smad1 Expression in Follicular Lymphoma: Jai Hyang Go; J Pathol Transl Med. 2015;49(3):243-248. Published online May 15, 2015; DOI: https://doi.org/10.4132/jptm.2015.03.30

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Abstract PDF: Background
Follicular lymphomas present with various immunohistologic patterns. The immunohistochemical markers used in the diagnosis of follicular lymphoma show variable degrees of sensitivity and specificity, and thus, additional germinal center markers are required. Smad1 has been reported to be overexpressed in follicular lymphoma, but little is known regarding the expression patterns of Smad proteins in human lymphoid tissue. Methods: In the present study, we performed immunohistochemistry for traditional germinal center markers and for Smad1 in human reactive lymphoid and follicular lymphoma tissues to investigate Smad1’s usefulness in the diagnosis of follicular lymphoma. Results: In the reactive germinal centers, most cells were positive for Smad1. Among the 27 follicular lymphoma cases, 17 of 21 (80%) were Smad1 positive, 17 of 27 (63%) were positive for CD10, and 23 of 27 (85%) were positive for Bcl6. Notably, three cases expressed CD10 only, and one only expressed Bcl6. All these cases were grade 3 tumors and showed follicular and diffuse growth patterns. Conclusions: These results indicate that Smad1 is a candidate as a germinal center marker. Furthermore, they suggest that the Smad signaling pathway might be involved in follicular lymphoma.

Case Study

Cystic Benign Phyllodes Tumor in the Inguinal Region: Jai Hyang Go; Korean J Pathol. 2013;47(6):583-586. Published online December 24, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.6.583

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The present lesion was the first reported case of a benign intracystic phyllodes tumor in the inguinal region. We report the case of a 51-year-old female patient who presented with an inguinal mass. A clinical diagnosis of malignant lymphoma was considered in this case. The resected tumor was well-circumscribed and showed numerous papillary nodular protrusions into a central cystic cavity (3.5×2.5 cm). The microscopic findings showed hyperplastic epithelium-lined cysts with leaf-like intraluminal epithelium-lined bland stromal projections. The epithelial cell linings were strongly positive for estrogen and progesterone receptors.

Citations

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Computed tomography and magnetic resonance imaging in diagnosis of metastatic pleural lesion with pleural effusion in patients with breast carcinoma
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Case Report

Collision of Adenocarcinoma and Schwannoma of the Stomach: A Case Report: Jai Hyang Go; Korean J Pathol. 2012;46(4):373-376. Published online August 23, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.4.373

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Abstract PDF

The simultaneous occurrence of an adenocarcinoma and schwannoma is extremely rare in the stomach, and only one such case has been previously reported, which presented as two separate masses. Indeed, the collision of these tumors has never been reported. We report the case of a 61-year-old male patient who was diagnosed with the synchronous development of a schwannoma and advanced mucinous adenocarcinoma of the stomach, in which the carcinoma cells focally invaded the schwannoma.

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What About Gastric Schwannoma? A Review Article
Sara Lauricella, Sergio Valeri, Gianluca Mascianà, Ida Francesca Gallo, Erica Mazzotta, Chiara Pagnoni, Saponaro Costanza, Lorenza Falcone, Domenico Benvenuto, Marco Caricato, Gabriella Teresa Capolupo
Journal of Gastrointestinal Cancer.2021; 52(1): 57. CrossRef
SYNCHRONOUS DEVELOPMENT OF SCHWANNOMA AND PRIMARY ADENOCARCINOMA IN THE STOMACH: A CASE REPORT
Algirdas Šlepavičius, Valdas Gasilionis, Alvydas Česas
Visuomenės sveikata.2019; 28(7): 75. CrossRef
Gastric Collision Tumors: An Insight into Their Origin and Clinical Significance
Adamantios Michalinos, Anastasia Constantinidou, Michael Kontos
Gastroenterology Research and Practice.2015; 2015: 1. CrossRef
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Diagnostic Pathology.2015;[Epub] CrossRef

Original Articles

Fine Needle Aspiration Cytology of Kikuchi's Lymphadenitis: with Emphasis on Differential Diagnosis with Tuberculosis.: Kang Min Han, Jai Hyang Go, Na Hye Myong, Wonae Lee; Korean J Pathol. 2011;45(6):626-631.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.6.626

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Abstract PDF

BACKGROUND
Although Kikuchi's lymphadenitis (KL) has been known to have characteristic cytological features, pathologists encounter difficulties in making a diagnosis with fine needle aspiration cytology (FNAC). The objective of this study was to assess the diagnostic pitfalls of KL with FNAC, particularly with emphasis on differential diagnosis with tuberculosis.
METHODS
FNAC of 10 patients with a histological diagnosis of KL and tuberculosis was reviewed.
RESULTS
Acidophilic cells were observed in all the 10 KL cases, even if the smears were insufficient. Crescentic histiocytes were seen in 8, granular background in 7, and karyorrhectic debris in 3 cases. Epithelioid histiocytes or neutrophils were not seen in any of the KL cases. Of the 10 cases of tuberculosis, acidophilic cells were observed in 6 cases, crescentic histiocytes in none of them, cheese-like background in 9, karyorrhectic debris in 8, epithelioid histiocytes in 4, and neutrophils in 8 cases.
CONCLUSIONS
The acidophilic cell could be the most sensitive but not the specific marker of KL with FNAC. The crescentic histiocytes might be the sensitive and considerably specific marker of KL. The cytological features distinguishing tuberculosis from KL may be cheese-like necrosis admixed with neutrophils and epithelioid histiocytes.

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Kikuchi–Fujimoto disease in the Eastern Mediterranean zone
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WHO Classification of Malignant Lymphomas in Korea: Report of the Third Nationwide Study.: Jin Man Kim, Young Hyeh Ko, Seung Sook Lee, Jooryung Huh, Chang Suk Kang, Chul Woo Kim, Yun Kyung Kang, Jai Hyang Go, Min Kyung Kim, Wan Seop Kim, Yoon Jung Kim, Hyun Jung Kim, Hee Kyung Kim, Jong Hee Nam, Hyung Bae Moon, Chan Kum Park, Tae In Park, Young Ha Oh, Dong Wha Lee, Jong Sil Lee, Juhie Lee, Hyekyung Lee, Sung Chul Lim, Kyu Yun Jang, Hee Kyung Chang, Yoon Kyung Jeon, Hye Ra Jung, Min Sun Cho, Hee Jeong Cha, Suk Jin Choi, Jae Ho Han, Sook Hee Hong, Insun Kim; Korean J Pathol. 2011;45(3):254-260.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.3.254

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Abstract PDF

BACKGROUND
The aim of study was to determine the relative frequency of malignant lymphoma according to World Health Organization (WHO) classification in Korea.
METHODS
A total of 3,998 cases diagnosed at 31 institutes between 2005 and 2006 were enrolled. Information including age, gender, pathologic diagnosis, site of involvement and immunophenotypes were obtained.
RESULTS
The relative frequency of non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL) was 95.4% and 4.6%, respectively. B-cell lymphomas accounted for 77.6% of all NHL, while T/natural killer (T/NK)-cell lymphomas accounted for 22.4%. The most frequent subtypes of NHL were diffuse large B-cell lymphoma (42.7%), extranodal marginal zone B-cell lymphoma (MZBCL) of mucosa-associated lymphoid tissue (19.0%), NK/T-cell lymphoma (6.3%) and peripheral T-cell lymphoma (PTCL), unspecified (6.3%), in decreasing order. The relative frequency of HL was nodular sclerosis (47.4%), mixed cellularity (30.6%), and nodular lymphocyte predominant (12.1%) subtypes. Compared with a previous study in 1998, increase in gastric MZBCL and nodular sclerosis HL, and slight decrease of follicular lymphoma, PTCL, and NK/T-cell lymphoma were observed.
CONCLUSIONS
Korea had lower rates of HL and follicular lymphoma, and higher rates of extranodal NHL, extranodal MZBCL, and NK/T-cell lymphoma of nasal type compared with Western countries. Changes in the relative frequency of lymphoma subtypes are likely ascribed to refined diagnostic criteria and a change in national health care policy.

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Korean Pediatric/Adolescent Lymphoma: Incidence and Pathologic Characteristics.: Seung Sook Lee, Jin Man Kim, Young Hyeh Ko, Jooryung Huh, Chang Suk Kang, Chul Woo Kim, Yun Kyung Kang, Jai Hyang Go, Min Kyung Kim, Wan Seop Kim, Yoon Jung Kim, Hyun Jung Kim, Hee Kyung Kim, Jong Hee Nam, Hyung Bae Moon, Chan Kum Park, Tae In Park, Young Ha Oh, Dong Wha Lee, Jong Sil Lee, Juhie Lee, Hyekyung Lee, Sung Chul Lim, Kyu Yun Jang, Hee Kyung Chang, Yoon Kyung Jeon, Hye Ra Jung, Min Sun Cho, Hee Jeong Cha, Suk Jin Choi, Jae Ho Han, Sook Hee Hong, Insun Kim; Korean J Pathol. 2010;44(2):117-124.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.2.117

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Abstract PDF

BACKGROUND
The Hematopathology Study Group of the Korean Society of Pathologists conducted a nation-wide retrospective analysis of Korean pediatric lymphoma, to provide pathologic data on pediatric/adolescent lymphoma subtypes and features.
METHODS
All lymphoma cases of all age groups were collected during a recent 2 year-period (2005-2006) from 32 institutes in Korea. Among 3,686 lymphoma patients, 142 who were age 18 or less were classified according to the World Health Organization (WHO) classification.
RESULTS
Among 142 pediatric/adolescent lymphoma patients, Hodgkin lymphoma accounted for 21 (14.8%) and non-Hodgkin lymphoma (NHL) for 121 (85.2%). Hodgkin lymphoma appears to be more common in the pediatric/adolescent age group than in the all-ages group (14.8% vs 4.4%). T- and natural killer cell-NHL was more common in the pediatric/adolescent age group than in the all ages group (46.3% vs 22%). The majority of Korean pediatric/adolescent NHL cases was composed of Burkitt lymphoma, T- or B-lymphoblastic lymphoma, anaplastic large-cell lymphoma, and diffuse large B-cell lymphoma. For lymphoma patients under the age of 6 years, most had B-lymphoblastic or Burkitt lymphoma, which commonly presented at extranodal sites.
CONCLUSIONS
The distribution of lymphoma subtypes in the pediatric/adolescent age group is quite different from the distribution of adults, but it was quite similar to distribution in Western countries.

Citations

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A Case of Nasal Type Extranodal NK/T Cell Lymphoma Incidentally Detected in a Child
Ha Jin Oh, Sang Hyun Park, Hae In Jang, Dong Hoon Lee, Yoo Duk Choi, Hee Jo Baek, Hoon Kook
Clinical Pediatric Hematology-Oncology.2015; 22(1): 76. CrossRef

Large Cell Neuroendocrine Carcinoma of the Lung: Report of three cases.: Jai Hyang Go, Sun Ree Jung, Dong Hwan Shin, Woo Hee Jung; Korean J Pathol. 1995;29(4):511-516.

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Abstract PDF: We report three cases of neuroendocrine tumors of the lung characterized by large pleomorphic cell with frequent mitosis, which show neuroendocrine differentiation by both light microscopy or electron microscopy and iminunohistochemistry. These tumors have been categorized as large cell neuroendocrine carcinoma by Travis et al.(1991) in contrast with non-small cell lung cancer with neuroendocrine differentiation. In the latter, neuroendocrine differentiation is not evident by light microscopy and must be demonstrated by imunohistochemstry or by electron microscopy. The prognosis of large cell neuroendocrine carcinoma, together with non-small cell lung cancer with neuroendocrine differentiation, appears to be worse than cancer without neuroendocrine differentiation and intermediate between atypical carcinoid and small cell lung cancer. Larger numbers of patients will be needed to demonstrate significant differences in survival.

Case Reports

Infiltrating Ductal Carcinoma of the Breast with Stromal Osteoclast-Like Multinucleated Giant Cell: A case report.: So Ya Paik, Sang Yeop Yi, Jai Hyang Go, Dong Hwan Shin; Korean J Pathol. 1996;30(1):61-64.

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Abstract PDF: Malignant tumors of the breast which contain stromal osteoclast-like, multinucleated giant cells are a rare entity of yet unknown clinical significance. These benign multinucleated giant cells are known to occur mostly in areas of prominent angiogenesis and in close association with tumor cells. Supplementary immunohistochemical and electronmicroscopic examinations indicate that the multinucleated giant cells are of histiocytic origin. We report on a case of infiltrating ductal carcinoma with stromal osteoclast-like multinucleated giant cells occurring in the right breast of a 37 year-old woman. Grossly, the tumor was characterized by a well-circumscribed dark brown, solid firm mass. Microscopically, multinucleated giant cells were found in the stroma intermingled with malignant tumor cells. The stroma showed only a small amount of mononuclear cell infiltration and a moderate degree of vascular proliferation. Immunohistochemical stains revealed the tumor cells to be positive for carcinoembryonic antigen, epithelial membrane antigen and cytokeratin while the multinucleated giant cells were positive for vimentin, CD68 and negative for all other stains tested. Ultrastructurally the multinucleated giant cells differed from tumor cells by having abundant cytoplasmic organelles such as rough endoplasmic reticulum, lysosomes, ribosomes, and vesicles but lacking desmosomes or other types of intercellular junctions. Other characteristic features of multinucleated giant cells included, indented nuclei and prominent cytoplasmic process.

Papillary Neoplasm of the Endolymphatic Sac: A report of two cases.: Jai Hyang Go, Yoon Jung Choi, Tae Seung Kim, Chan Il Park; Korean J Pathol. 1996;30(2):150-154.

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Abstract PDF: 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.

Ectopic Umbilical Liver Associated with Intrauterine Fetal Death: An autopsy case.: Jai Hyang Go, Sang Ho Cho; Korean J Pathol. 1996;30(3):269-271.

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Abstract PDF: Ectopic liver in the umbilicus is very rare, and a few cases have been reported in the world. It is thought that an increased intraabdominal pressure resulting in entrapment of liver cell nests causes the presence of liver in the umbilicus. It relates to neonatal problem such as infection. We report a case of ectopic umbilical liver in a stillborn male of 28 gestational weeks. His mother discovered loss of fetal movement 2 days before admission, and intrauterine fetal death was diagnosed by ultrasonography. Grossly, the umbilical cord was markedly swollen. On cut section, a well circumscribed, oval round, tan-colored soft mass was noted within the cord. Histologically, it consisted of hepatic cords without bile ducts. The umbilical vessels were distorted by the ectopic liver, and contained thrombi. These findings suggest that ectopic umbilical liver results in the intrauterine fetal death

Original Article

Analysis of Histological Findings and Estrogen and Progesterone Receptor Status in Luteal Phase Defect Caused by Delayed Ovulation and Clomiphen Treatment.: Kyu Rae Kim, Hee Jeong Ahn, Jai Hyang Go, Dong Hee Choi, Byoung Goo Yoon; Korean J Pathol. 1996;30(12):1106-1115.

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Abstract PDF: Luteal phase defect (LPD) is an ovulatory disorder of considerable clinical importance that leads to delayed endometrial maturation and inadequate endometrium for blastocyst implantation. This disorder is implicated in infertility and recurrent spontaneous abortion. We analyzed the endometrial histological maturation, and the estrogen receptor(ER) and progesterone receptor(PR) status in patients with unexplained delayed ovulation, and in patients with ovulation induction by clomiphen citrate. The purpose of this study was to determine whether the length of the follicular phase influences the endometrial histological maturation and the hormonal receptor status, and to know the effect of clomiphen citrate on the endometrium. In the delayed ovulation group, the endometrium was characterized by an irregular outpouching and dilated lumina of the glands, a decreased secretory activity and predecidualization, and a decreased number of granulocytes in the stroma. In the clomiphen citrate-ovulation induction group, glandular proliferation was markedly diminished with poorly convoluted and narrow glands, secretory activity was decreased, stroma was undecidualized, and there was an absence of granulocytes. ER expression was increased in the glandular epithelium in the delayed ovulation group, and both ER and PR expressions were markedly decreased in the glandular epithelium and stromal cells in the ovulation induction group. Endometrial maturation and differentiation may be diminished by increased estrogenic and relatively deficient progesterone effects in patients with delayed ovulation. The hormonal receptor status might also be influenced by hormonal changes. Clomiphen citrate successfully induced ovulation in patients with delayed ovulation, however, endometrial proliferation and maturation were markedly suppressed. This might be related to the lower pregnancy rate and higher abortion rate in patients with clomiphen citrate induced ovulation.

Case Reports

Metanephric Adenoma of the Kidney.: Yoon La Choi, Jung Won Lee, Jai Hyang Go, Cheol Keun Park; Korean J Pathol. 1998;32(1):72-75.

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Abstract PDF: Metanephric adenoma is a rare renal epithelial tumor. Its light microscopic features are very characteristic, and immunohistochemical and electron microscopic studies are not critical to the diagnosis. The literature indicate that, to date, the tumor has behaved in a benign fashion, and predominantly but not exclusively occurred in middle-aged women. It occurs in a wide range up to 11 cm and is usually an incidental finding but may be symptomatic with hematuria or flank pain. Recently, we have experienced a case of renal tumor showing distinctive adenomatous features, which is incidentally found in a 52-year-old female. This tumor is confined to the renal cortex and is well-circumscribed with a characteristic uniform and orderly proliferation of compact well-differentiated small tubules lined by bland oval cells with a very low level of mitotic activity. The term metanephric adenoma is appropriate for this tumor because it accurately describes its bland proliferation of tubules and reflects the embryonic architectural and cytological appearance of this proliferation. The pattern of the tumor, with its occasional papillary glomeruloid- like bodies and foci of elongated tubules, is reminiscent of the fetal metanephric kidney.

Primitive Neuroectodermal Tumor of the Kidney: A case report .: Sang Yong Song, Eun Youn Cho, Jung Won Lee, Jai Hyang Go, Mi Kyung Kim, Dae Shick Kim, Young Hyeh Ko; Korean J Pathol. 1998;32(3):231-236.

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Abstract PDF: Peripheral primitive neuroectodermal tumor (pPNET), a rare, highly aggressive neoplasm of indetermined histogenesis, occurs typically in the soft tissues of the chest wall and the paraspinal region. Comprehensive diagnostic studies including histological, ultrastructural, immunohistochemical and molecular analyses have been stressed to diagnose this entity. We report a case of primary renal PNET which was incidentally found in a 59-year-old man who presented with generalized weakness for 4 months. He was diagnosed as a non-insulin dependent diabetes mellitus 15 years ago and has been made well by oral therapy. An ill-defined mass, measuring 3.5 3 cm, located in the left kidney and perirenal fat, was incidentally found by ultrasonogram during a renal diabetic examination. The mass was resected because of the unresponsiveness against one-year chemotherapy and radiation therapy. Grossly, a homogeneously solid, gray-white mass, measuring 2.8 1.8 cm, was noted in the mid portion of renal cortex. The mass showed severe adhesion to the perirenal fatty tissue. Microscopically, tumor cells were rather uniform, small round with scanty cytoplasm and often showed rosette formation. Ultrastructurally, they showed membrane-bound dense core granules, measuring 125~150 nm, intercellular junctions and microvillous cytoplasmic projections. The tumor cells were uniformly immunoreactive for neuron-specific enolase and were focally immunoreactive for CD99 (013), chromogranin, synaptophysin and cytokeratin. They were not reactive for S-100 protein, vimentin, Leu-7, leukocyte common antigen, desmin and smooth muscle actin. To our knowledge, this is the smallest renal PNET in literature.

Original Article

Cyclin D1 Expression in 101 Cases of Breast Carcinoma.: Duck Hwan Kim, Eun Sook Nam, Hyung Sik Shin, Jin Woo Ryu, Jai Hyang Go, Young Lyun Oh, Sang Yong Song, Dae Shick Kim, Min Chul Lee; Korean J Pathol. 1998;32(4):266-272.

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Abstract PDF: Cyclin D1, a cell cycle regulator essential for G1 phase progression, is a candidate proto-oncogene implicated in pathogenesis of several human carcinomas including breast carcinoma. We studied the cyclin D1 expression in 101 cases of primary breast carcinoma tissues. The overexpression of cyclin D1 was immunohistochemically demonstrated in 34 (37.8%) of 90 cases of invasive breast carcinoma. Positive cyclin D1 staining was seen in 32 of 79 invasive ductal carcinomas, and 2 of 3 mucinous carcinomas. All 5 medullary carcinomas, 2 invasive lobular carcinomas, and 1 metaplastic carcinoma were negative. Cyclin D1 overexpression was observed in 9 of 11 ductal carcinoma in situ (DCIS). Normal epithelial components, either ductal or lobular, were not immunoreactive for cyclin D1. No significant correlations were observed between cyclin D1 immunoreactivity and other parameters including tumor size, clinical stage, nuclear or histologic grades, lymphatic or angioinvasion, lymph node metastasis, and immunohistochemical status of progesterone receptor, p53 and c-erbB-2. The overexpression of cyclin D1 was positively correlated with estrogen receptor status (p=0.025). Based on our results, the cyclin D1 protein aberration may play a role in tumorigenesis of breast carcinoma, but does not seem to have prognostic value in invasive breast carcinoma without hormonal treatment.

Case Report

Ultrastructural Findings of Hereditary Sensory and Autonomic Neuropathies, Type IV and II.: Jai Hyang Go, Yeon Lim Suh; Korean J Pathol. 1998;32(7):535-539.

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Abstract: Hereditary sensory and autonomic neuropathies (HSAN) are disorders of hereditary neuropathy mainly affecting sensation and also accompanying autonomic nervous system dysfunction. They are divided into five subtypes based on inheritance pattern and clinical manifestation. Among HSAN, type II is characterized by autosomal recessive inheritance, presentation at later stage of life, slow progression and mainly sensation abnormalities. The main pathology of the peripheral nerve is the absence of myelinated nerve fibers. Type IV is very rare disorder and only a few cases have been reported. It is characterized by autosomal recessive inheritance, presentation at birth as failure to thrive, retarded motor development, unexplained pyrexia and rapidly progressive and severe clinical course. The main pathology of the peripheral nerve is a loss of unmyelinated and small myelinated nerve fibers. We report two cases of type IV and one case of type II especially focusing on ultrastructural findings, which are characteristic of and diagnostic for HSAN.

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