Journal of Pathology and Translational Medicine

Original Article

IMP3, a Promising Prognostic Marker in Clear Cell Renal Cell Carcinoma: Ji Young Park, Misun Choe, Yuna Kang, Sang Sook Lee; Korean J Pathol. 2014;48(2):108-116. Published online April 28, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.2.108

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Background

Insulin-like growth factor II mRNA-binding protein 3 (IMP3) has been reported as a prognostic biomarker in various cancers. To validate IMP3 as a prognostic biomarker in renal cell carcinoma (RCC), we investigated the expression of IMP3, p53, and Ki-67, and their associations with clinicopathologic outcomes.

Methods

We studied 148 clear cell RCCs (CCRCCs) from patients who underwent radical nephrectomy. The expression levels of IMP3, p53, and Ki-67 were assessed by immunohistochemical staining and the clinical and pathologic parameters were retrospectively reviewed.

Results

Twenty-nine percent of CCRCCs expressed IMP3. Forty-one percent of IMP3-immunopositive tumors developed metastases, while only 11.4% of IMP3-negative tumors developed metastases (p<.001). A Kaplan-Meier curve showed that patients with IMP3-immunopositive tumors had lower metastasis-free survival and cancer-specific survival than did those with IMP3-immunonegative tumors (p<.001 and p<.001, respectively). Expression of high Ki-67 proliferation index was also associated with a higher metastatic rate. In the multivariate Cox regression analysis, pT stage and IMP3-positivity were independently associated with disease-specific survival.

Conclusions

IMP3 is an independent prognostic biomarker for patients with CCRCC to predict metastasis and poor outcome.

Citations

Citations to this article as recorded by

IMP3 Immunohistochemical Expression Is Related with Progression and Metastases in Xenografted and Cutaneous Melanomas
Natividad Martin-Morales, Miguel Padial-Molina, Isabel Tovar, Virginea De Araujo Farias, Pedro Hernández-Cortés, Esperanza Ramirez-Moreno, Mercedes Caba-Molina, Justin Davis, Alejandro Carrero Castaño, Jose Mariano Ruiz de Almodovar, Pablo Galindo-Moreno,
Pathobiology.2024; 91(2): 132. CrossRef
circRARS synergises with IGF2BP3 to regulate RNA methylation recognition to promote tumour progression in renal cell carcinoma
Yuenan Liu, Kailei Chen, Yi Shou, Sen Li, Jun Wang, Qingyang Zhang, Ziwei Huang, Jiaju Xu, Mingfeng Li, Di Liu, Huageng Liang, Hongmei Yang, Xiaoping Zhang
Clinical and Translational Medicine.2023;[Epub] CrossRef
Prognostic value of insulin‑like growth factor 2 mRNA‑binding protein 3 and vascular endothelial growth factor‑A in patients with primary non‑small‑cell lung cancer
Jiannan Liu, Ying Liu, Wenjing Gong, Xiangshuo Kong, Congcong Wang, Shuhua Wang, Aina Liu
Oncology Letters.2019;[Epub] CrossRef
Epithelial‑mesenchymal transition in colorectal carcinoma cells is mediated by DEK/IMP3
Shuping You, Yun Guan, Weihong Li
Molecular Medicine Reports.2017;[Epub] CrossRef

Case Reports

A Soft Tissue Perineurioma and a Hybrid Tumor of Perineurioma and Schwannoma: Ji Young Park, Nam Jo Park, Sang Pyo Kim, Kun Young Kwon, Sang Sook Lee; Korean J Pathol. 2012;46(1):75-78. Published online February 23, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.1.75

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Abstract PDF

Perineuriomas are composed of differentiated perineurial cells. Perineuriomas have been recently recognized by the immunoreactivity for epithelial membrane antigen (EMA). Microscopically, perineuriomas show proliferation of spindle cells with wavy nuclei and delicate elongated bipolar cytoplasmic processes. The tumor cells are usually negative for the S-100 protein. Ultrastructurally, perineurial cells reveal slender, nontapered processes containing pinocytic vesicles and discontinuous basal lamina. Interestingly, hybrid tumors of benign peripheral nerve sheath tumor (PNST) have been recently reported by using immunohistochemical and ultrastructural investigations. Herein, we report a case of soft tissue perineurioma arising in the skin of a 56-year-old female; another case of a hybrid tumor of perineurioma and schwannoma in the posterior mediastinum occurred in a 53-year-old male, which is the first case of the hybrid PNST tumor reported in Korea.

Citations

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Neurogenic tumours of the posterior mediastinum and differential diagnosis considerations
Michael A den Bakker, Annikka Weissferdt
Histopathology.2024; 84(1): 238. CrossRef
Hybrid tumors with perineurioma components: a systematic review of the literature and illustrative case
Karina A. Lenartowicz, Dileep D. Monie, Kimberly K. Amrami, Christopher J. Klein, Caterina Giannini, Robert J. Spinner
Acta Neurochirurgica.2022; 165(4): 935. CrossRef
Hybrid Schwannoma/Perineurioma: Morphologic Variations and Genetic Profiles
Takanori Hirose, Anna Kobayashi, Sumihito Nobusawa, Naoe Jimbo
Applied Immunohistochemistry & Molecular Morphology.2021; 29(6): 433. CrossRef
Mesenchymal Tumors of the Mediastinum: An Update on Diagnostic Approach
Joon Hyuk Choi, Jae Y. Ro
Advances in Anatomic Pathology.2021; 28(5): 351. CrossRef
Neurogenic Tumors of the Mediastinum
Erika F. Rodriguez, Robert Jones, Daniel Miller, Fausto J. Rodriguez
Seminars in Diagnostic Pathology.2020; 37(4): 179. CrossRef
A Rare Perineurioma/Granular Cell Tumor Hybrid Peripheral Nerve Sheath Tumor
Koorosh Haghayeghi, Gladys Telang, Sonja Chen, Jack Bevivino, Shamlal Mangray, Yiang Hui, Leslie Robinson-Bostom
The American Journal of Dermatopathology.2020; 42(10): 762. CrossRef
Hybrid peripheral nerve sheath tumors
Emine KILIÇ BAĞIR, Arbil AÇIKALIN, Gülfiliz GÖNLÜŞEN, Suzan ZORLUDEMİR, Mehmet Ali DEVECİ
Cukurova Medical Journal.2019; 44(3): 804. CrossRef
Primary intraosseous hybrid epithelioid schwannoma/perineurioma in the proximal tibia: a case report of benign hybrid neoplasm with local hypercellularity
Yuejiao Lang, Dawei Liu, Pei Xiang, Jilin Wang, Yang Li
Diagnostic Pathology.2019;[Epub] CrossRef
Hybrid peripheral nerve sheath tumors: report of five cases and detailed review of literature
Nasir Ud Din, Zubair Ahmad, Jamshid Abdul-Ghafar, Rashida Ahmed
BMC Cancer.2017;[Epub] CrossRef
Primary intraosseous hybrid nerve sheath tumor of femur: A hitherto undescribed occurrence in bone with secondary aneurysmal bone cyst formation resulting in pathological fracture
Louis Tsun Cheung Chow
Pathology - Research and Practice.2015; 211(5): 409. CrossRef
Mesenchymal tumours of the mediastinum—part II
Michael A. den Bakker, Alexander Marx, Kiyoshi Mukai, Philipp Ströbel
Virchows Archiv.2015; 467(5): 501. CrossRef
Primary pleural hybrid cellular schwannoma/perineurioma: A case report
Danny Soria-Céspedes, Carlos Robles-Vidal, Arturo Gómez-González, Rosalinda Peñaloza-Ramírez, Carlos Ortiz-Hidalgo
Respiratory Investigation.2014; 52(4): 269. CrossRef
Hybrid peripheral nerve sheath tumour with intermingled perineuriomatous and schwannomatous areas reflected in skin ultrasonography image
H. Saeki, K. Ito, Y. Nobeyama, T. Ishiji, M. Fukunaga, H. Nakagawa
Clinical and Experimental Dermatology.2014; 39(6): 747. CrossRef
Périneuriome extraneural des tissus mous localisé au nez
A. Zaouak, R. Benmously, M. Belhadj Salah, W. Koubaa, A. Debbiche, I. Mokhtar
Annales de Dermatologie et de Vénéréologie.2013; 140(8-9): 540. CrossRef

A Case of Intimal Sarcoma Arising in the Left Common Iliac Artery.: Ji Young Park, Kun Young Kwon, Hyoung Tae Kim, Sang Sook Lee; Korean J Pathol. 2011;45(3):311-314.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.3.311

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Abstract PDF: Primary tumors of the great vessels are rare. Most encountered cases are sarcomas which most commonly develop in the aorta, pulmonary artery, and inferior vena cava. We experienced an intimal sarcoma arising in the left common iliac artery in a 68-year-old male, who suffered from claudication in his left lower extremity for a year and was diagnosed as arteriosclerosis obliterans, clinically. Bypass surgery was performed on the obstructive lesion. Grossly, the vascular lumen was filled with dark hemorrhagic materials. Microscopically, the lesion showed proliferation of anaplastic spindle cells with a marked nuclear atypia, arranged haphazardly. There were numerous mitotic figures. Foci of cholesterol clefts were also found in the intima. Immunohistochemically, the tumor cells were positive for vimentin, smooth muscle actin, and cytokeratin in certain areas. Stains for CD34, desmin, myosin heavy chain, caldesmon, and S-100 protein were negative. A pathologic diagnosis was made as intimal sarcoma with myofibroblastic differentiation.

Original Articles

Comparative Study of Relative Value for Diagnostic Procedure of Surgical Pathology in Korea and United States.: Ilseon Hwang, Yu Na Kang, Kun Young Kwon, Sun Young Kwon, Sang Pyo Kim, Sang Sook Lee, Hye Ra Jung, Mi Sun Choe; Korean J Pathol. 2011;45(1):9-14.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.1.9

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Abstract PDF

BACKGROUND
Pathologic examination is a very important diagnostic procedure. It is the most important method to decide the therapeutic plan and to predict the prognosis of cancer patients. The Resource-Based Relative Value Scale (RBRVS) is a schema used to determine how much money medical providers should be paid. In Korea, a modified RBRVS has been used since the year 2000.
METHODS
We researched the July 2010 RBRVS for Korea and the US medicare. The individual Relative Evaluation Index (REI) is defined as the ratio of an individual RBRVS to the mean RBRVS. The REIs of pathologic examination in Korea and America were compared.
RESULTS
For an endoscopic biopsy specimen, the pathologic examination REI in Korea was 55.4% of the American REI. The Korean REI of a prostate biopsy (8 sites) was only 5.7% of the American REI. The Korean REI was 28.1% of the American REI for the hysterectomy for uterine myoma, and the Korean REI was 67.6% of the American REI for resection of stomach or colon cancer.
CONCLUSIONS
The RBRVS of pathologic examination in Korea remains undervalued. Considering the importance of pathologic examination in medicine, the RBRVS in Korea should be increased.

Citations

Citations to this article as recorded by

Diminutive and Small Colorectal Polyps: The Pathologist's Perspective
Yun Kyung Kang
Clinical Endoscopy.2014; 47(5): 404. CrossRef
Early Colorectal Epithelial Neoplasm in Korea: A Multicenter Survey of Pathologic Diagnosis
Yun Kyung Kang, So-Young Jin, Mee Soo Chang, Jung Yeon Kim, Gyeong Hoon Kang, Hye Seung Lee, Jin Hee Sohn, Ho Sung Park, Kye Won Kwon, Mi Jin Gu, Young Hee Maeng, Jong Eun Joo, Haeng Ji Kang, Hee Kyung Kim, Kee-Taek Jang, Mi Ja Lee, Hee Kyung Chang, Joon
Korean Journal of Pathology.2013; 47(3): 245. CrossRef

Use of Calretinin, CD56, and CD34 for Differential Diagnosis of Schwannoma and Neurofibroma.: Ji Young Park, Hoon Park, Nam Jo Park, June Sik Park, Hyun Jung Sung, Sang Sook Lee; Korean J Pathol. 2011;45(1):30-35.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.1.30

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Abstract PDF

BACKGROUND
It is important to differentiate between schwannomas and neurofibromas for the cases in which the histopathologic features overlap. Depending on the tumor type, surgeons can decide on a treatment method and whether to preserve or sacrifice the nerve; the possibility of malignant transformation in the case of neurofibromas also needs to be considered.
METHODS
We studied 101 cases of schwannoma and 103 cases of neurofibroma. All the hematoxylin and eosin slides for these cases were reviewed, and tissue microarrays were prepared from the representative areas. Immunohistochemical analysis was performed using antibodies for S-100 protein, calretinin, CD56 and CD34.
RESULTS
All the tumors except 3 neurofibromas were positive for the S-100 protein. Calretinin was found in 26.7% of the schwannomas (27/101), but it was not found in any of the neurofibromas. CD56 was positive in 77.2% of the schwannomas (78/101) and in 9.8% of the neurofibromas (10/102). CD34 was positive in 42.5% of the schwannomas (43/101) and in 80.2% of the neurofibromas (81/101). Statistically, calretinin was significantly specific for schwannomas (p<0.001) and CD56 was also sensitive for these tumors (p<0.001). On the other hand, a CD34 expression seemed highly sensitive (p<0.001) for neurofibromas.
CONCLUSIONS
We concluded that combined immunohistochemical analysis for calretinin, CD56, and CD34 may be very useful for differentiating schwannomas from neurofibromas.

Citations

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Lung schwannomas, an unusual entity: A series of five cases
NaziaM Walvir, RumanaH Makhdoomi, Meesa Zargar, Aiffa Aiman, Shadab Maqsood
Lung India.2023; 40(1): 70. CrossRef
A Spectrum of Histomorphological and Immunohistochemical Expression Profiles of S-100, CD56 and Calretinin in Benign Peripheral Nerve Sheath Tumours
Poornima Jaiswal, Anand CD, Jaison Jacob John
Cureus.2023;[Epub] CrossRef
An unusual diffuse CD34 staining in an olfactory groove cellular schwannoma: Case report
Marios Theologou, Jorge D. Perez Ruiz, Panagiotis Varoutis, Nicolaos Flaris, Nikolaos `Skoulios
Archivos de Neurociencias.2023;[Epub] CrossRef
An unusual diffuse CD34 staining in an olfactory groove cellular schwannoma: Case report
Marios Theologou, Jorge D. Perez Ruiz, Panagiotis Varoutis, Nicolaos Flaris, Nikolaos `Skoulios
Archivos de Neurociencias.2023;[Epub] CrossRef
Intranodal Neurofibroma: A Case Report and Literature Review
Steven H. Adams, Tara L. Huston, Daniel Lozeau
The American Journal of Dermatopathology.2022; 44(4): 306. CrossRef
A rare case of pseudoglandular schwannoma
Fadime Eda GÖKALP SATICI, Hamide SAYAR
Journal of Surgery and Medicine.2022; 6(4): 1. CrossRef
Gastric Schwannoma as an Important and Infrequent Differential Diagnosis of Gastric Mesenchymal Tumours: A Case Report and Review of Literature
Abdalla Saad Abdalla Al-Zawi, Salma Lahmadi, Saman Jalilzadeh Afshari, Ipshita Kak, Salem Alowami
Cureus.2022;[Epub] CrossRef
Spindle cell proliferations of the sigmoid colon, rectum and anus: a review with emphasis on perineurioma
Patrice Grech, John B Schofield
Histopathology.2020; 76(3): 342. CrossRef
Large retroperitoneal schwannoma: a rare cause of chronic back pain
Milan Radojkovic, Dragan Mihailovic, Miroslav Stojanovic, Danijela Radojković
Journal of International Medical Research.2018; 46(8): 3404. CrossRef
Nasal Septal Schwannoma
Hyun Jin Min, Seok Chan Hong, Kyung Soo Kim
Journal of Craniofacial Surgery.2017; 28(1): e97. CrossRef
Neurofibroma of the Colon: A Diagnostic Mimicker of Gastrointestinal Stromal Tumor
Soomin Ahn, Choon Sik Chung, Kyoung-Mee Kim
Case Reports in Gastroenterology.2016; 10(3): 674. CrossRef
Solitary Epibulbar Neurofibroma in Older Adult Patients
Thais Shiota Tanaka, Victor M. Elner, Hakan Demirci
Cornea.2015; 34(4): 475. CrossRef
Syncytial nuclear aggregates in normal placenta show increased nuclear condensation, but apoptosis and cytoskeletal redistribution are uncommon
S.J. Coleman, L. Gerza, C.J.P. Jones, C.P. Sibley, J.D. Aplin, A.E.P. Heazell
Placenta.2013; 34(5): 449. CrossRef
Analysis of syncytial nuclear aggregates in preeclampsia shows increased sectioning artefacts and decreased inter-villous bridges compared to healthy placentas
S.J. Calvert, C.J.P. Jones, C.P. Sibley, J.D. Aplin, A.E.P. Heazell
Placenta.2013; 34(12): 1251. CrossRef

Expression of MUC1 and MUC4 and Its Prognostic Significance in Non-Small Cell Lung Carcinoma.: Ji Min Jeon, Hye Won Lee, Ji Young Park, Hye Ra Jung, Ilseon Hwang, Sun Young Kwon, Mi Sun Choe, Yu Na Kang, Sang Pyo Kim, Sang Sook Lee, Won Il Choi, Kun Young Kwon; Korean J Pathol. 2010;44(4):397-403.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.4.397

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Abstract PDF

BACKGROUND
Mucin (MUC)1 and MUC4 (MUC1, 4) are high molecular weight glycoproteins expressed in normal and malignant epithelial cells, and these expressions are related to the prognosis of some carcinomas. In non-small cell lung carcinoma (NSCLC), the relationship between MUC1, 4 expressions and their prognostic significance is not well known. We evaluated these relationships in a series of NSCLC: 1) between MUC1, 4 expression levels and histologic subtypes, and 2) between high expression of MUC1, 4 and their prognostic significance.
METHODS
We performed immunohistochemical staining for MUC1, 4 in paraffin-embedded tissues from 165 NSCLC cases arranged in a tissue microarray.
RESULTS
We found a significant correlation between MUC1, 4 expressions and NSCLC histologic subtypes (p < 0.05). High MUC1 expression was characteristic of adenocarcinoma. Low MUC1, 4 expressions were characteristic of squamous cell carcinoma. In adenocarcinoma, we found significant association between diffuse MUC1 expression and short patient survival (p = 0.005). In squamous cell carcinoma, diffuse MUC4 expression showed long patient survival trend (p = 0.128).
CONCLUSIONS
MUC1, 4 expression levels were significantly correlated with NSCLC histologic subtypes. Diffuse MUC1 expression was significantly associated with shortened survival in NSCLC patients, especially in adenocarcinoma.

Citations

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Inhibition of MUC1-C Increases ROS and Cell Death in Mouse Embryonic Stem Cells
Jeong-A Park, Sangkyu Park, Jun-Kyu Choi, Myung-Kwan Han, Younghee Lee
International Journal of Stem Cells.2020;[Epub] CrossRef
Assessing the prognostic significance of MUC4β in mucoepidermoid carcinoma of the salivary glands: An immunohistochemical study
Poonam R. Sawant, Anita Spadigam, Anita Dhupar, Shaheen Syed, Karla Carvalho
Heliyon.2019; 5(11): e02753. CrossRef
Ultrasensitive cytosensing based on an aptamer modified nanobiosensor with a bioconjugate: Detection of human non-small-cell lung cancer cells
Tanveer A. Mir, Jang-Hee Yoon, N.G. Gurudatt, Mi-Sook Won, Yoon-Bo Shim
Biosensors and Bioelectronics.2015; 74: 594. CrossRef
Expression of MUC1 and MUC4 in Gallbladder Adenocarcinoma
Su-Mi Kim, Sun-Ju Oh, Bang Hur
Korean Journal of Pathology.2012; 46(5): 429. CrossRef
MUC4 and MUC1 Expression in Adenocarcinoma of the Stomach Correlates with Vessel Invasion and Lymph Node Metastasis: An Immunohistochemical Study of Early Gastric Cancer
Yukihiro Tamura, Michiyo Higashi, Sho Kitamoto, Seiya Yokoyama, Masahiko Osako, Michiko Horinouchi, Takeshi Shimizu, Mineo Tabata, Surinder K. Batra, Masamichi Goto, Suguru Yonezawa, Fazlul H. Sarkar
PLoS ONE.2012; 7(11): e49251. CrossRef
Prognostic significance of membrane-associated mucins 1 and 4 in gastric adenocarcinoma
ILSEON HWANG, YU NA KANG, JIN YOUNG KIM, YOUNG ROK DO, HONG SUK SONG, KEON UK PARK
Experimental and Therapeutic Medicine.2012; 4(2): 311. CrossRef

Detection of Human Papillomavirus DNA 16/18 in Cervical Adenocarcinomas by Polymerase Chain Reaction.: Sang Sook Lee, Nam Jo Park, Chong Guk Yoon; Korean J Pathol. 1995;29(4):502-510.

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Abstract PDF: Twenty-five paraffin-embedded tumor tissues were analyzed for detection of HPV 16 and 18 in cervical adenocarcinoma by polymerase chain reaction with type specific primers and by non-radioactive Southern blot hybridization for confirmation . The suitability of paraffin-embedded tissue as PCR material was confirmed by successful amplification of 100% of cervical specimens with human -globin specific primer. Eighty four percent of the cervical adenocarcinoma tissues were positive for HPV 16 and/or 18. HPV 16 positive rate was 68%, HPV 18 was 60%. The double infection with HPV 16 and 18 was found in 44%. Three cases of the negative specimen in PCR for each type of HPV DNA 16 and 18 were positive in Southern blot hybridization. The total positive rate was 92% for HPV 16 and/or HPV 18, HPV 16 positive rate was 80%. HPV 18 was 72%. The double infection with HPV 16 and 18 was 60%. These results suggest that the pattern of HPV types 16 and 18 is closely associated with carcinogenesis of cervical cancers. HPV type 18 appears to be preferentially related to cervical adenocarcinoma and the poor prognosis of these patients. Therefore, determination of HPV DNA type in cervical carcinoma patients is important in treatment and prognosis.

Castration-induced Apoptosis in the Rat Prostate.: Ki Kwon Kim, Sang Sook Lee; Korean J Pathol. 1998;32(6):431-442.

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Abstract: This study was carried out to investigate the morphologic findings and process of castration-induced apoptosis in the rat prostate. The experimental group was treated with bilateral orchiectomy followed by sequential sacrifices at 1, 2, 3, 4, 5, 6, 7 days and 2, 3 weeks (6 rats, respectively). Ventral prostate was extirpated and examined by light microscopic and immunohistochemical, ultrastructural observation. Apoptotic index increased by 4 days after castration and decreased thereafter. ApopTag stain revealed brownish granular pattern in the nucleus of apoptotic cells. DNA fragmentation rate was 0.5% in the control group and began to increase by 1 day after castration and reached to 11.1% by 4 days and decreased thereafter. PCNA stain showed brownish granular pattern in the nucleus of some epithelial cells of the prostatic glands. PCNA labelling index was 2.4% in the control group and reached peak by 3 days after castration and decreased thereafter. Electron microscopically, there was chromatin condensation with margination toward the nuclear membrane by 1 day after castration. Also noted were condensation of cytoplasm, dilatation of RER and nuclear fragmentation. Apoptotic bodies were formed and phagocytosed by adjacent cells and some apoptotic bodies were found in the lumen of acini. Based on these results, it can be concluded that castration-induced prostatic involution is the result of apoptosis. Detection of DNA fragmentation with ApopTag is a more a accurate method to identify not only apoptotic body formation itself but also the previous step of apoptotic body formation. PCNA labelling index to identify the cellular proliferation seems to play an active role in the early step of apoptosis and be a good tool for investigation of apoptosis.

Expression of bcl-2 and p53 Protein in Primary Gastric Lymphomas.: Young Rok Cho, Yu Na Kang, Sang Sook Lee, Hong Suk Song, Soo Sang Sohn, Dong Sug Kim; Korean J Pathol. 1998;32(11):978-984.

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Abstract: The bcl-2 gene is a proto-oncogene which extends cell survival by blocking apoptosis. Bcl-2 expression has been detected in many types of nodal and MALT lymphoma. The p53 gene is a tumor suppressor gene and p53 mutation is the most common genetic alteration in human malignancies. The relationship between the expression of bcl-2 and p53 protein in primary gastric lymphoma has been rarely reported. The authors investigated the expression of bcl-2 and p53 protein in 37 cases of primary gastric lymphoma by immunohistochemical method using bcl-2 and p53 monoclonal antibodies. There were five cases of low grade B-cell MALT lymphomas and thirty two cases of high grade B-cell lymphomas. Fifteen of 37 cases (41%) showed bcl-2 protein expression in the cytoplasm of tumor cells and 26 cases (70%) showed p53 protein expression in the nucleus of tumor cells. Bcl-2 protein was detected in 4 of 5 (80%) low grade MALT lymphomas, and in 11 of 32 (34%) high grade lymphomas. There was no significant correlation between bcl-2 expression and histologic grade of primary gastric lymphomas (p>0.05). p53 protein was positive in 25 of 32 (78%) high grade lymphomas, and in 1 of 5 (20%) low grade MALT lymphomas. The expression of p53 protein is significantly higher in high grade lymphoma than in low grade MALT lymphoma (p<0.05). The p53 expression in the bcl-2 negative cases (86%) was significantly higher than in the bcl-2 positive cases (47%). There was an inverse relationship between bcl-2 and p53 expression in primary gastric lymphoma. These results suggest that bcl-2 and p53 expression in primary gastric lymphoma may be involved in the transition from low grade MALT lymphoma to high grade lymphoma.

bcl-2 and p53 Protein Expression in Multiple Myeloma and Non-tumorous Plasma Cells A study related to survival.: Yu Na Kang, Kwan Kyu Park, Kun Young Kwon, Sang Sook Lee, Eun Sook Chang, Young Jae Lee; Korean J Pathol. 1999;33(3):179-186.

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Abstract PDF: The gene product of bcl-2 (B-cell leukemia/lymphoma-2) was suggested to suppress programmed cell death (apoptosis) of tumor cells and be involved in the development of multiple myeloma. However, the normal plasma cells also express the protein. It is unclear whether the expression of bcl-2 in multiple myeloma is of normal character or of regulatory adaptation in association with neoplastic transformation. p53 was also suggested to be involved in tumor progression since mutations on p53 were found in multiple myeloma. In order to find the relationship between the expression patterns of bcl-2 and p53 in tumor cells of multiple myeloma and non-neoplastic plasma cells, we examined 38 cases of multiple myeloma and 10 cases of nasal polyp immunohistochemically. Furthermore, expression of bcl-2 and p53, mitosis, clinical stage and infiltrative pattern of tumor cells in bone marrow were also evaluated in association with the survival of patients. By immunostaining with anti-bcl-2 and p53 monoclonal antibody, 37 out of 38 cases of multiple myeloma and all of 10 cases of nasal polyp were positive for bcl-2 but only 7 cases of multiple myeloma were positive for p53. Marked dysplasia, low percentage of bcl-2 expression, and increased mitoses were correlated with poor prognosis. Based on these observations, we suggest that bcl-2 and p53 are involved in tumorigenesis of multiple myeloma and the survival of patients would be influenced by dysplastic change, mitosis and degree of bcl-2 expression.

Case Reports

Undescended Testis in the Complete Testicular Feminization Syndrome A report of three cases.: Yu Na Kang, Kwan Kyu Park, Kun Young Kwon, Sang Sook Lee, Jung Ho Lee, Jong In Kim; Korean J Pathol. 1999;33(5):371-375.

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Abstract PDF: The testicular feminization is the most common type of male pseudohermaphroditism. Mutation of androgen receptor gene impairs normal sexual differentiation in genetic male (46, XY) and subsequently develops secondary female characteristics. We report three cases of complete testicular feminization syndrome with normal development of female external genitalia, but with blindly ended vagina and inguinal or pelvic masses. Microscopic examination of the testes and their adnexa had three components: 1) A testis composed of immature tubules, prominent Leydig cells and a spindle cell stroma resembling ovarian stroma with hamartomatous nodule or Sertoli cell adenoma, 2) a white, whorled, firm, smooth muscle body in the medial pole of the testis, and 3) a lateral adnexal cysts of varying sizes.

Signet Ring Cell Carcinoma of the Prostate A report of two cases.: Yu Na Kang, Sang Sook Lee, Tae Jin Lee, Jae Yoon Ro; Korean J Pathol. 1999;33(5):385-368.

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Abstract PDF: Primary signet ring cell carcinoma of the prostate is extremely rare and about 18 cases have been reported in the literature. We report two cases of primary signet ring cell carcinoma of the prostate, arising in 79-year-old and 65-year-old men. Both cases were the poorly differentiated adenocarcinoma of the prostate with many signet ring cells. Signet ring cells were positive for prostatic specific antigen and prostatic acid phosphatase but negative for neutral and acid mucins. In summary, the signet ring cell carcinoma of the prostate is a rare variant of poorly differentiated adenocarcinoma of the prostate. The orgin of the prostate should be considered in cases of metastatic signet ring cell carcinoma, particularly when the signet ring cells are negative for neutral and acid mucins. Prostatic specific antigen and prostatic acid phosphatase should also be performed to confirm the primary signet ring cell carcinoma of the prostate.

Original Articles

Expression of bcl-2 and p53 Protein in Premalignant Lesion and Invasive Squamous Cell Carcinoma of the Uterine Cervix.: Hyun Chang Joo, Kwan Kyu Park, Sang Sook Lee, Eun Sook Chang, Tae Sung Lee, Soon Do Cha, Young Jae Lee; Korean J Pathol. 2000;34(4):280-287.

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Abstract PDF: In order to understand the possible involvement of bcl-2 and p53 proteins in the tumorigenesis of the cervical cancer and precancerous lesion, we studied the expression patterns of bcl-2 and p53 proteins in 25 cases of carcinoma in situ, 12 cases of microinvasive cervical carcinoma, and 37 cases of invasive cervical carcinoma, respectively. By immunohistochemistry, 76% of in situ carcinoma, 83.3% of microinvasive cervical carcinoma, and 60.9% of invasive cervical carcinoma were positive for bcl-2, while the staining of basal cell layers, columnar cells, and squamous metaplastic epithelium of normal cervical epithelium were positive for bcl-2 in 91.9%, 73.1%, and 81.8% of cases, respectively. Furthermore, two out of fourteen cases of invasive cervical carcinoma with lymph node metastasis were positive for bcl-2. p53 was expressed in 72.7% of condyloma or dysplasia, 12% of in situ carcinomas, 33.3% of microinvasive cervical carcinoma, and 43.5% of invasive cervical carcinomas without metastasis. Six out of fourteen cases of invasive cervical carcinoma with lymph node metastasis were positive for p53 immunostaining. In contrast, 5.4% of basal cells and 9.1% of squamous epithelium, and none of the columnar cells in normal cervical epithelium were positive for p53. In summary, the bcl-2 protein was highly expressed in the proliferative lesion of reserve cells, such as normal reserve cells, columnar cells, squamous metaplasia, carcinoma in situ, and microinvasive squamous cell carcinoma. p53 expression was increased in condyloma, carcinoma in situ, and invasive carcinoma where the reserve cells were non-proliferative. Based on these findings, we propose that bcl-2 and p53 protein are involved in the development and progression of uterine cervical carcinoma.

Expression of Transforming Growth Factor-beta1 in Cyclosporine-Induced Nephropathy in Rats.: Yu Na Kang, Kwan Kyu Park, Mee Yul Hwang, Kun Young Kwon, Sang Sook Lee, Eun Sook Chang, Hyun Chul Kim; Korean J Pathol. 2000;34(9):642-651.

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Abstract PDF: Cyclosporine nephropathy was induced by intraperitoneal injection of cyclosporine 25 mg/kg in Sprague-Dawley rats daily for 1, 4, 8, and 12 weeks to clarify the relationship between cyclosporine nephropathy and the expression of TGF-beta1 with extracellular matrix deposition. On light microscopic examination, the kidneys in the 12 week cyclosporine-treated rats showed focal or striped fibrosis, vacuolization of tubular cells, and injury of endothelial cells. Immunohistochemically, TGF-beta1 protein was strongly expressed in the cyclosporine-treated rat kidneys, especially in the glomerular endothelial cells, interstitial endothelial cells, tubular epithelial cells, and parietal cells in the Bowman's capsule of the glomerulus as well as the periglomerular arterioles. The amount of TGF-beta1 expression was correlated with the morphological change in the cyclosporine-treated rats. Extracellular matrix, such as fibronectin and collagen IV, was also expressed in the endothelial cells of the glomerulus and the interstitium. It can be concluded, therefore that TGF-beta1 protein is probably involved in the early stage of fibrogenesis in cyclosporine nephropathy. It can be postulated that cyclosporine nephropathy results from the accumulation of extracellular matrix associated with the increase of TGF-beta1 transcription. Therefore, these results could be used in reducing fibrosis in cyclosporine nephropathy.

Case Report

Metastatic Alveolar Soft Part Sarcoma Presented with a Dura Mass: A Case Report.: Sun Young Kwon, Hyun Chang Joo, Kun Young Kwon, Sang Sook Lee, Chul Ho Sohn, Man Bin Yim, Sang Pyo Kim; Korean J Pathol. 2001;35(2):180-183.

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Abstract PDF: Alveolar soft part sarcoma, accounting for less than 1% of all soft tissue sarcomas, is known for late metastases to the lung, bone and brain. We have examined a case of metastatic alveolar soft part sarcoma to the brain in a 34-year-old woman. Computed tomography of the brain revealed a well enhancing dura based mass of the left temporal area. The patient had a previous history of surgery for alveolar soft part sarcoma from the right thigh at the age of 24 years. She underwent total removal of the dural mass under the clinical impression of the meningioma. Grossly, a well-circumscribed, pale tan and solid mass was 3.4 x 3.2 x 2.4 cm and easily detached from the attached dura. Histologically, the tumor showed typical features of alveolar soft part sarcoma. Immunohistochemically, tumor cells were positive for muscle related antibodies. Ultrastructural examination showed rod-shaped membrane bound crystals and electron-dense granules in the cytoplasm of tumor cells.

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