Journal of Pathology and Translational Medicine

Original Articles

Histologically confirmed distant metastatic urothelial carcinoma from the urinary bladder: a retrospective review of one institution’s 20-year experience: Youngeun Yoo, Junghye Lee, Heae Surng Park, Min-Sun Cho, Sun Hee Sung, Sanghui Park, Euno Choi; J Pathol Transl Med. 2021;55(2):94-101. Published online December 3, 2020; DOI: https://doi.org/10.4132/jptm.2020.10.19

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Background
Urothelial carcinoma (UC) accounts for roughly 90% of bladder cancer, and has a high propensity for diverse differentiation. Recently, certain histologic variants of UC have been recognized to be associated with unfavorable clinical outcomes. Several UC studies have also suggested that tumor budding is a poor prognostic marker. Distant metastasis of UC after radical cystectomy is not uncommon. However, these metastatic lesions are not routinely confirmed with histology.
Methods
We investigated the histopathologic features of 13 cases of UC with biopsy-proven distant metastases, with a special emphasis on histologic variants and tumor budding.
Results
Lymph nodes (6/13, 46%) were the most common metastatic sites, followed by the lung (4/13, 31%), liver (4/13, 31%), and the adrenal gland (2/13, 15%). The histologic variants including squamous (n=1), micropapillary (n=4), and plasmacytoid (n=1) variants in five cases of UC. Most histologic variants (4/5, 80%) of primary UCs appeared in the metastatic lesions. In contrast, high-grade tumor budding was detected in six cases (46%), including one case of non-muscle invasive UC. Our study demonstrates that histologic variants are not uncommonly detected in distant metastatic UCs. Most histologic variants seen in primary UCs persist in the distant metastatic lesions. In addition, high-grade tumor budding, which occurs frequently in primary tumors, may contribute to the development of distant metastasis.
Conclusions
Therefore, assessing the presence or absence of histologic variants and tumor budding in UCs of the urinary bladder, even in non-muscle invasive UCs, may be useful to predict distant metastasis.

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Do Histology and Primary Tumor Location Influence Metastatic Patterns in Bladder Cancer?
Hyung Kyu Park
Current Oncology.2023; 30(10): 9078. CrossRef

Double cocktail immunostains with high molecular weight cytokeratin and GATA-3: useful stain to discriminate in situ involvement of prostatic ducts or acini from stromal invasion by urothelial carcinoma in the prostate: Junghye Lee, Youngeun Yoo, Sanghui Park, Min-Sun Cho, Sun Hee Sung, Jae Y. Ro; J Pathol Transl Med. 2020;54(2):146-153. Published online February 10, 2020; DOI: https://doi.org/10.4132/jptm.2019.11.12

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Abstract PDF

Background
Distinguishing prostatic stromal invasion (PSI) by urothelial carcinoma (UC) from in situ UC involving prostatic ducts or acini with no stromal invasion (in situ involvement) may be challenging on hematoxylin and eosin stained sections. However, the distinction between them is important because cases with PSI show worse prognosis. This study was performed to assess the utility of double cocktail immunostains with high molecular weight cytokeratin (HMWCK) and GATA-3 to discriminate PSI by UC from in situ UC involvement of prostatic ducts or acini in the prostate.
Methods
Among 117 radical cystoprostatectomy specimens for bladder UCs, 25 cases showed secondary involvement of bladder UC in prostatic ducts/acini only or associated stromal invasion and of these 25 cases, seven cases revealed equivocal PSI. In these seven cases with equivocal PSI, HMWCK, and GATA-3 double immunohistochemical stains were performed to identify whether this cocktail stain is useful to identify the stromal invasion.
Results
In all cases, basal cells of prostate glands showed strong cytoplasmic staining for HMWCK and UC cells showed strong nuclear staining for GATA-3. In cases with stromal invasion of UC, GATA-3-positive tumor cells in the prostatic stroma without surrounding HMWCK-positive basal cells were highlighted and easily recognized. Among seven equivocal cases, two cases showed PSI and five in situ UC in the prostate. In two cases, the original diagnoses were revised.
Conclusions
Our study suggested that HMWCK and GATA-3 double stains could be utilized as an adjunct method in the distinction between PSI by UC from in situ UC involving prostatic ducts or acini.

Citations

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Aberrant expression of GATA3 in metastatic adenocarcinoma of the prostate: an important pitfall
João Lobo, Nazario P Tenace, Sofia Cañete‐Portillo, Isa Carneiro, Rui Henrique, Roberta Lucianò, Lara R Harik, Cristina Magi‐Galluzzi
Histopathology.2024; 84(3): 507. CrossRef
Utility of D2-40, Cytokeratin 5/6, and High–Molecular-weight Cytokeratin (Clone 34βE12) in Distinguishing Intraductal Spread of Urothelial Carcinoma From Prostatic Stromal Invasion
Oleksii A. Iakymenko, Laurence M. Briski, Katiana S. Delma, Merce Jorda, Oleksandr N. Kryvenko
American Journal of Surgical Pathology.2022; 46(4): 454. CrossRef

Brief Case Reports

Tailgut Cyst in a Neonate: A Case Report: Ji Hyen Lee, Yun Suk Lee, So Yeon Shim, Su Jin Cho, Eun Ae Park, Soon Sup Chung, Sanghui Park; J Pathol Transl Med. 2016;50(4):315-317. Published online April 6, 2016; DOI: https://doi.org/10.4132/jptm.2015.11.27

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Epidemiology, diagnostic approach and therapeutic management of tailgut cysts: A systematic review
Aikaterini Mastoraki, Ilias Giannakodimos, Karmia Panagiotou, Maximos Frountzas, Dimosthenis Chrysikos, Stylianos Kykalos, Georgios E. Theodoropoulos, Dimitrios Schizas
International Journal of Clinical Practice.2021;[Epub] CrossRef
Pediatric congenital buttock sinus tract:10-year experience in a single institution
Kai Wang, Chunhui Peng, Wenbo Pang, Dayong Wang, Tingchong Zhang, Zengmeng Wang, Dongyang Wu, Yajun Chen
BMC Pediatrics.2019;[Epub] CrossRef

Cytomegalovirus-Associated Intussusception with Florid Vascular Proliferation in an Infant: Heejung Park, Sanghui Park, Young Ju Hong, Sun Wha Lee, Min-Sun Cho; J Pathol Transl Med. 2015;49(3):270-273. Published online May 15, 2015; DOI: https://doi.org/10.4132/jptm.2015.04.01

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Severe Postnatal Cytomegalovirus Enterocolitis in Immunocompetent Term Infants Requiring Total Parenteral Nutrition
Annaleise R. Howard-Jones, Giancarlo H. Cristerna-Tarrasa, Rabia Khan, Michael Stormon, Susan Arbuckle, Philip N. Britton
JPGN Reports.2021; 2(3): e110. CrossRef
Retrospective multicenter matched case–control study on the risk factors for intussusception in infants less than 1 year of age with a special focus on rotavirus vaccines – the German Intussusception Study
Doris Oberle, Marcus Hoffelner, Jutta Pavel, Dirk Mentzer, Immanuel Barth, Ursula Drechsel-Bäuerle, Brigitte Keller-Stanislawski
Human Vaccines & Immunotherapeutics.2020; 16(10): 2481. CrossRef
Ebola Virus Causes Intestinal Tract Architectural Disruption and Bacterial Invasion in Non-Human Primates
Ronald Reisler, Xiankun Zeng, Christopher Schellhase, Jeremy Bearss, Travis Warren, John Trefry, George Christopher, Mark Kortepeter, Sina Bavari, Anthony Cardile
Viruses.2018; 10(10): 513. CrossRef

Case Report

Cervical Lymphadenopathy Mimicking Angioimmunoblastic T-Cell Lymphoma after Dapsone-Induced Hypersensitivity Syndrome: Min Young Rim, Junshik Hong, Inku Yo, Hyeonsu Park, Dong Hae Chung, Jeong Yeal Ahn, Sanghui Park, Jinny Park, Yun Soo Kim, Jae Hoon Lee; Korean J Pathol. 2012;46(6):606-610. Published online December 26, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.6.606

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Abstract PDF

A 36-year-old woman presented with erythematous confluent macules on her whole body with fever and chills associated with jaundice after 8 months of dapsone therapy. Her symptoms had developed progressively, and a physical examination revealed bilateral cervical lymphadenopathy and splenomegaly. Excisional biopsy of a cervical lymph node showed effacement of the normal architecture with atypical lymphoid hyperplasia and proliferation of high endothelial venules compatible with angioimmunoblastic T-cell lymphoma. However, it was assumed that the cervical lymphadenopathy was a clinical manifestation of a systemic hypersensitivity reaction because her clinical course was reminiscent of dapsone-induced hypersensitivity syndrome. A liver biopsy revealed drug-induced hepatitis with no evidence of lymphomatous involvement. Intravenous glucocorticoid was immediately initiated and her symptoms and clinical disease dramatically improved. The authors present an unusual case of cervical lymphadenopathy mimicking angioimmunoblastic T-cell lymphoma as an adverse reaction to dapsone.

Citations

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Morphologic Spectrum of Lymphadenopathy in Drug Reaction With Eosinophilia and Systemic Symptoms Syndrome
Hui-Chun Chen, Ren Ching Wang, Huey-Pin Tsai, L. Jeffrey Medeiros, Kung-Chao Chang
Archives of Pathology & Laboratory Medicine.2022; 146(9): 1084. CrossRef
Antibacterial antibiotic-induced drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome: a literature review
Shiva Sharifzadeh, Amir Hooshang Mohammadpour, Ashraf Tavanaee, Sepideh Elyasi
European Journal of Clinical Pharmacology.2021; 77(3): 275. CrossRef
Drug-Induced Hypersensitivity Syndrome: A Clinical, Radiologic, and Histologic Mimic of Lymphoma
Faaria Gowani, Bradley Gehrs, Teresa Scordino
Case Reports in Hematology.2018; 2018: 1. CrossRef
In vitro testing for diagnosis of idiosyncratic adverse drug reactions: Implications for pathophysiology
Abdelbaset A. Elzagallaai, Michael J. Rieder
British Journal of Clinical Pharmacology.2015; 80(4): 889. CrossRef
Dapsone-induced drug reaction with eosinophilia and systemic symptoms syndrome, misdiagnosed as lymphoma
Bomi Shin, So Young Park, Sun-Young Yoon, Eun-Hye Shin, Young-Joo Yang, Hyung-Jin Cho, Il-Young Jang, Dong-Uk Kang, Tae-Bum Kim, You Sook Cho, Hee-Bom Moon, Hyouk-Soo Kwon
Allergy, Asthma & Respiratory Disease.2013; 1(4): 400. CrossRef
T-cell lymphoma presenting as drug rash with eosinophilia and systemic symptoms syndrome
Mi-Ae Kim, Hye-Soo Yoo, Sun Hyuk Hwang, Yoo Seob Shin, Dong-Ho Nahm, Hae-Sim Park
Allergy Asthma & Respiratory Disease.2013; 1(3): 280. CrossRef

Original Articles

Morphometric Analysis for Pulmonary Small Cell Carcinoma Using Image Analysis.: Sun Min Jeong, Seung Yeon Ha, Jungsuk An, Hyun Yee Cho, Dong Hae Chung, Na Rae Kim, Sanghui Park; Korean J Pathol. 2011;45(1):87-91.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.1.87

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Abstract PDF

BACKGROUND
There are few studies of how to diagnose small cell lung cancer in cytological tests through morphometric analysis. We tried to measure and analyze characteristics of small cell carcinoma in lung by image analysis.
METHODS
We studied three types of cytologic specimens from 89 patients who were diagnosed with small cell lung cancer by immunohistochemistry. We measured area, perimeter, maximal length and maximal width of cells from small cell carcinoma using image analysis.
RESULTS
In lung aspirates, the nuclear mean area, perimeter, maximal length and maximal width of small cell lung cancer were 218.69 microm2, 55 microm, 18.48 microm and 14.65 microm. In bronchial washings, nuclear measurements were 194.66 microm2, 50.07 microm, 16.27 microm and 14.1 microm. In pleural fluid, values were 177.85 microm2, 48.09 microm, 15.7 microm and 13.37 microm.
CONCLUSIONS
Nuclear size of small cell lung carcinoma is variable and depends on the cytology method. Nuclei are spindle-shaped and larger in small cell carcinoma from lung aspirates than in bronchial washings or pleural fluid. The cytoplasms of the cells in bronchial washings and pleural fluid were swollen. Therefore, one should consider morphologic changes when trying to diagnose small cell lung cancer through cytological tests.

Citations

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Interobserver Variability in Diagnosing High-Grade Neuroendocrine Carcinoma of the Lung and Comparing It with the Morphometric Analysis
Seung Yeon Ha, Joungho Han, Wan-Seop Kim, Byung Seong Suh, Mee Sook Roh
Korean Journal of Pathology.2012; 46(1): 42. CrossRef

The Analysis and Clinical Usefulness of HPV DNA Chip Test in the Uterine Cervix.: Joo hyeon Jeong, Hyun Yee Cho, Na Rae Kim, Dong Hae Chung, Sanghui Park, Seung Yeon Ha; Korean J Pathol. 2010;44(1):77-82.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.1.77

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Abstract PDF

BACKGROUND
The genotypes of human papillomavirus (HPV) are important in carcinogenesis in uterine cervical cancer and may be different in geographic distribution.
METHODS
In 2,086 women, we analyzed the prevalence of HPV and HPV genotypes in uterine cervix by HPV-DNA chip test (n = 2,086), cytology (PAP smear, n = 1997) and biopsy (n = 546).
RESULTS
Of the 2,086 cases, 1,019 cases (48.8%) were HPV-positive and 1,067 cases (51.2%) were negative for HPV. Single infection occurred most commonly (72.1% of women). HPV genotypes in the high-risk and low-risk groups, respectively were HPV-16/-58/-18/-52/-53 and HPV-70/-6/-11. The detection rates of HPV-70 in subjects older than 50 years increased significantly (p < 0.05). Infection in high risk subjects was detected in high grade lesions compared with infection in low risk subjects (p < 0.05).
CONCLUSIONS
HPV-16/-58/-18/-52/-53/-70/-6/-11 genotypes were common in the patient group similar to findings in East Asia. HPV-70 infection is predominant in those older than 40 years.

Citations

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Current Status of and Perspectives on Cervical Cancer Screening in Korea
Sung-Chul Lim, Chong Woo Yoo
Journal of Pathology and Translational Medicine.2019; 53(4): 210. CrossRef
Cervical cytology of atypical squamous cells, cannot exclude high-grade squamous intra-epithelial lesion: significance of age, human papillomavirus DNA detection and previous abnormal cytology on follow-up outcomes
Chang Ohk Sung, Young Lyun Oh, Sang Yong Song
European Journal of Obstetrics & Gynecology and Reproductive Biology.2011; 159(1): 155. CrossRef
Cytomorphologic Features According to HPV DNA Type in Histologically Proven Cases of the Uterine Cervix
In Ho Choi, So-Young Jin, Dong Wha Lee, Dong Won Kim, Yoon Mi Jeen
The Korean Journal of Pathology.2011; 45(6): 612. CrossRef

Case Report

Ovarian Endometrioid Adenocarcinoma with a Yolk Sac Tumor Component.: Dong Hae Chung, Sanghui Park, Hee Eun Kyung, Na Rae Kim, Seung Yeon Ha, Soyi Lim, Hyun Yee Cho; Korean J Pathol. 2009;43(6):570-574.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.6.570

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Abstract PDF: Ovarian endometrioid adenocarcinoma (EAC) with a yolk sac tumor (YST) component is extremely rare. Only twelve cases have been reported in the English literature. We report here two additional cases of this rare tumor. The YST component showed classic microscopic features, and immunohistochemically stained positive for alpha-fetoprotein (AFP), but negative for cytokeratin 7 (CK7), epithelial membrane antigen (EMA), estrogen receptor (ER) and progesterone receptor (PR). The EAC appeared to blend into the YST in several areas and immunohistochemically stained positive for CK7, EMA, ER, and PR, but negative for AFP.

Original Article

The Usefulness of the HPV DNA Microchip Test for Women with ASC-US.: Hee Eun Kyeong, Seung Yeon Ha, Dong Hae Chung, Na Rae Kim, Sanghui Park, Hyun Yee Cho; Korean J Pathol. 2009;43(3):254-259.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.3.254

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Abstract PDF

BACKGROUND
This study was performed to ascertain the usefulness of the human papillomavirus (HPV) DNA microchip test for the screening and management of women with atypical squamous cells of undetermined significance (ASC-US).
METHODS
The subject group consisted of 534 patients, and all of whom were diagnosed as ASC-US according to a Papanicolaou smear, and they all underwent concomitant HPV DNA microchip test.
RESULTS
The occurrence rates of overall squamous lesions and high risk lesion (cervical intraepithelial neoplasia grade 2 and grade 3, and invasive carcinoma) of the HPV-positive ASC-US patients were significantly higher than those of the HPV-negative ASC-US patients. High risk lesion was detected more frequently among the older patients and the patients with HPV 56, 33 or 70. On the follow-up HPV DNA microchip test, only 1 of 11 (9.1%) HPV type-switched women developed squamous lesion compared with 8 of 13 (61.6%) HPV type-persistent women who developed squamous lesion.
CONCLUSIONS
The HPV DNA microchip test is useful for the management of ASC-US patients. HPV-positive ASC-US patients should undergo a HPV DNA microchip test periodically. If the same genotype of HPV is persistent on the follow-up test, more increased surveillance is needed.

Citations

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Enhanced disease progression due to persistent HPV-16/58 infections in Korean women: a systematic review and the Korea HPV cohort study
Jaehyun Seong, Sangmi Ryou, JeongGyu Lee, Myeongsu Yoo, Sooyoung Hur, Byeong-Sun Choi
Virology Journal.2021;[Epub] CrossRef

Case Report

Pulmonary Adenocarcinoma with a Micropapillary Pattern Detected by Bronchial Washing: A Brief Case Report.: Jae Hong Park, Seung Yeon Ha, Hyun Yee Cho, Dong Hae Chung, Na Rae Kim, Sanghui Park; Korean J Cytopathol. 2008;19(2):206-208.; DOI: https://doi.org/10.3338/kjc.2008.19.2.206

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Abstract PDF: Adenocarcinomas with micropapillary patterns are generally aggressive and show lymphotropism. Only a few reports on pulmonary adenocarcinoma with micropapillary patterns have described cytologic findings. A 70-year-old Korean woman was admitted to the hospital because of intermittent dry cough and chest pain. Cytology after bronchial washing showed neoplastic cells in small, angulated, cohesive clusters consisting of 3-20 cells without a fibrovascular core. The resected right middle lobe showed a tumor occupying almost the entire lobe. Histologically, about 90% of neoplastic cells proliferated with micropapillary morphology in the background of bronchioloalveolar carcinoma. Cytologic smears of a bronchial washing showing tumor cells in small, cohesive clusters without a fibrovascular core may indicate an adenocarcinoma with micropapillary pattern.

Original Article

The Usefulness of Cervicovaginal Cytology as a Primary Screening Test.: Jae Hong Park, Seung Yeon Ha, Hyun Yee Cho, Dong Hae Chung, Na Rae Kim, Sanghui Park; Korean J Cytopathol. 2008;19(2):107-110.; DOI: https://doi.org/10.3338/kjc.2008.19.2.107

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Abstract PDF

We evaluated the usefulness of cervicovaginal cytology as a primary screening test by analyzing the cytologic and histological diagnoses of 2,254 women. Cervicovaginal cytology had 93.0% sensitivity, 86.1% specificity, 88.2% positive predictive value, and 91.7% of negative predictive value. Cervicovaginal cytology as a primary screening test showed much higher specificity but slightly lower sensitivity than HPV DNA testing. However, the sensitivity of cervicovaginal cytology will be improved continuously due to the development of liquid-based cytology. We regard cervicovaginal cytology as a good primary screening test for cervical intraepithelial neoplasia or carcinoma.

Citations

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Working Conditions that Impact the Workload of Cytotechnologists: A Study Calculating the Actual Man Power Required
Soo Il Jee, Yong Ho Ahn, Hwa-Jeong Ha, Jeong Eun Kang, Jun Ho Won
The Korean Journal of Clinical Laboratory Science.2021; 53(2): 174. CrossRef

Case Report

Ectopic Liver Associated with the Gallbladder: A Brief Case Report.: Hee Eun Kyeong, Younghee Park, Sanghui Park; Korean J Pathol. 2008;42(2):128-130.

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Abstract PDF: Ectopic liver is a rare entity that has been previously identified during abdominal exploration for other surgery and this has usually been described in the vicinity of the liver such as on the gallbladder, hepatic ligaments, diaphragm, thoracic cavity, adrenal glands, pancreas, omentum, spleen, esophagus and umbilical cord. Most cases of ectopic liver reported in the literature were located in the gallbladder. We report here on a case of ectopic liver related to the gallbladder, and this was encountered during an elective laparoscopic cholecystectomy.

Original Article

Renal Cell Carcinoma Associated with Xp11.2 Translocation: Clinicopathologic and Immunohistochemical Findings of 4 Cases.: Sanghui Park, Ji Eun Kwon, Yeon Lim Suh; Korean J Pathol. 2005;39(6):406-411.

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Abstract PDF: BACKGROUND
The new WHO classification includes the recently described renal cell carcinomas (RCC) that are associated with several different translocations, involving chromosome Xp11.2, and they all result in gene fusions involving the TFE3 gene. The authors describe the clinicopathologic and immunohistochemical findings of 4 patients who had the morphologic features of RCC with Xp11.2 translocations.
METHODS
Among 9 surgically resected and pathologically proven pediatric RCCs, 4 showed a typical RCC histopathology with the Xp11.2 translocation. Immunohistochemical stains were performed for TFE3, AE1/AE3, epithelial membrane antigen, vimentin, HMB45, S-100 protein and CD10.
RESULTS
The 4 study subjects included one male and 3 females, and their chief complaints were gross hematuria and abdominal pain. Histologically, the tumors showed two different histologic types: type 1 tumors (2 cases) that corresponded to those of ASPL-TFE3 RCC, and type 2 tumors (2 cases) that corresponded to PRCC-TFE3 RCC. Nuclear TFE3 immunostaining was seen in 3 cases. All the tumors were immunoreactive for CD10, and vimentin and cytokeratin were expressed in 3 cases and HMB-45 was expressed in 2 cases.
CONCLUSIONS
Our results show that significant numbers of pediatric RCC are translocation-related. Therefore, when one encounters an RCC in the pediatric population, the possibility of a translocation-related RCC should be kept in mind.

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