Journal of Pathology and Translational Medicine

Volume 24(1); March 1990

Original Articles

Immunohistochemical Study on the Ha-ras p21 Expression in the Gastric Carcinoma.: Kwang Min Lee, Joo Yong Yoo; Korean J Pathol. 1990;24(1):1-9.

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Abstract PDF: We have investigated an immunohistochemical expression of the Human-Ha-ras oncogene product p21 in tumor cells of the primary mass and metastatic lymph nodes with different histological features of gastric cancer by using avidinbiotin complex immunoperoxidase method in formalin-fixed tissue sections from 73 cases of primary tumor mass and 23 cases of metastatic lymph node. Histologic type of the gastric cancer was classification. The results obtained were as follows: 1) Expression of Ha-ras p21 was consistantly increased in the well differentiated tubular adenocarcinoma as compared with poorly differentiated tubular adenocarcinoma (p<0.01), and was substantially decreased in mucinous carcinoma and signet ring cell carcinoma. 2) Signet ring cell carcinoma showed that positive immunoperoxidase reaction for Ha-ras p21 exhibited in the majority of immature signet ring cell with scant cytoplasm rather than in the mature signet ring cells which have abundant cytoplasm filled with mucin. This findings indicate that mucin production from the tumor cell was not correlated with activation of ras gene in the tumor tissue of gastric carcinoma. 3) In general Ha-ras p21 expression was enhanced in the metastatic tumor cells of the regional lymph node compared with primary tumor, especially it was consistantly increase in the well differentiated tubular adenocarcinoma.

The Significance of Nesidiodysplasia of the Pancreas.: Soo Im Choi, Woo Hee Jeong, Chan Il Park; Korean J Pathol. 1990;24(1):10-15.

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Abstract PDF: To elucidate the significance of the nesidiodysplasia of pancreas, histological re-evaluation and immunohistochemical studies for insulin, glucagon and somatostatin were done on 16 consecutive cases (5 premature babies, 2 stillborns, 5 infants and 3 adults) in which paraffin blocks of the pancreas were available. Only one infant was hypoglycemic. All 16 pancreases showed changes of nesidiodysplasia which appeared immunohistochemically to have isulin, glucagon and /or somatostatin. The histologic patterns of nesidiodysplasia included ductoendocrine proliferation, endocrine cell dysplasia, adenomatosis, septal islet, islket cell hypertrophy and islet hypertrophy. All the patterns of nesidiodysplasia except for the adenomatosis were seen in premature babies, infants, stillborns and adults with or without hypoglycemia. The adenomatosis was found only in the hypoglycemic infant. The result suggests that all patterns of nesidiodysplasia of other than the adenomatosis does not imply the pathologic basis of hypoglycemia.

Detection of Human Papillomavirus DNA by In Situ Hybridization using Biotinylated DNA Probes in Cervical Intraepithelial Neoplasias and Squamous Cell Carcinomas.: Sang Sook Lee, Ki Kwon Kim, Chai Hong Chung, Seung Won Jin, U Ik Sohn; Korean J Pathol. 1990;24(1):16-26.

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Abstract PDF: The authors examined 9 condylomas, 26 cervical intraepithelial neoplasms(CIN) and 22 invasive squamous cell carcinomas for the presence of human papillomavirus(HPV) DNA sequences by DNA-DNA in situ hybridization. In situ hybridization revealed target HPV DNA sequences mostly in the nuclei of the superficial cells from epithelium which contained either maturation or koilocytotic atypias. With the use of biotinylated HPV DNA probes 6/11, 16/18 and 31/33/35, 42 of the 57(73.7%) were positive with HPV-6/11, 23 with HPV-16/18, 32 with HPV-31/33/35 and 18 with two or more mixed probes. HPV-31/33/35 was wht most prevalent in CIN and invasive squamous cell carcinomas, follwed by HPV-16/18. The incidence of HPV DNA increased from 66.7% to 86.4% with increasing severity of the lesions from condylomas to invasive squamous cell carcinomas. Flat condyloma was most freuently accompanied by CIN.

Morphological Observations on the Epidermal Development of Human Fetal Skin.: Joong Seok Seo, Kye Yong Song, Je G Chi; Korean J Pathol. 1990;24(1):27-38.

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Abstract PDF: To observe developing process of human fetal skin during intrauterine life, morphological studies in light microscopic level were made based on 27 human embryos and 76 fetuses ranging from 4 to 40 gestation weeks. The fetuses were the products of induced abortion and were found to have no associated diseases of congenital anomalies at the autopsy. Ten different portions of the body were sampled and examined. They were scalp, forehead, face, chest, abdomen, back, palm, sole, finger and toe. In embryos two different portions; cephalic and caudal portions were examined: The following results were obtained: 1) A single layer of undifferentiated cell was the primitive epidermis at the 4th week and it was followed by two layered epidermis consisting of periderm and primitive basal cell layer. Epidermal ridges started to develop along with primitive eccrine and hair germs as clustering of basal cells at the llth week. Stratum inter-medium was formed at the 12th week, and primitive granular cell layers and keratin formation in association with hair follicles at the 19th week forming earliest adult type epidermis, followed by progressive maturation. 2) The thickness of the fetal epidermis and keratin layer increased as the fetal age approached to the term with its slightly different developmental pattern by the site of body. Cephalic protions developed slightly earlier than the other parts. 3) The developmental pattern of various portions of epidermis could be categorized into three groups; (1) scalp, forehead and face; (2) chest, abdomen and back; (3) palm, sole, finger and toe.

Morphological Observations on the Hair Development of Human Fetal Skin.: Kil Seo Kim, Joong Seok Seo, Key Yong Song, Je G Chi; Korean J Pathol. 1990;24(1):39-49.

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Abstract PDF: The developing process of the hair of the fetal skin was studied. The ages of 103 human embryos and fetuses ranged from 4 to 40 gestation weeks. Ten different sites were selected, i.e., scalp, forehead, cheek, chest, abdomen, back, palm, sole, finger and toe. For the embryos 3 sites were studied, i.e., cephalic, trunk, and caudal portions. Following results were made: 1) The primitive hair germ was first noted the 10th week in the face skin as nubbins of mesenchymal cells beneath discrete foci of crowdes, elongated germinative epithelial cells. The developing hair germs and hair pegs were observes at the cephalic portion by 11 weeks. At 15 weeks the hair pegs including hair germs were noted in the trunk skin. The bulbous hair peg stage started at the 16th week in the cephalic portion and at the 18th week in the trunk. 2) Relative number of fetal hairs progressively increase up to 20 weeks of gestation but, thereafter decreased although it was different by the site of the body. 3) The diameter of fetal hair follicles increased with fetal age to the term with slight difference by the portion of body. 4) The developmental process of hair was more rapid in the cephalic portion than the trunk in views of morphologic changes of the hair structures, number and diameter of hair follicles.

Case Report

Ectopic Hamartomatous Thymoma: A case report.: Joon Mee Kim, Nam Hee Won, Seung Yong Paik; Korean J Pathol. 1990;24(1):50-57.

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Abstract PDF: A 49-year old man was admitted to the Korea university hospital, department of surgery, for evaluation of anterior neck mass which was slowly growing for five years. His past history was unremarkable except for known hypertension for several years. Physical examination revealed high blood pressure, measuring 180 mmHg in systolic phase and 120 mmHg in diastolic phase. A soft nontender mass was palpated at anterior neck just above the sternal notch with smooth surface and its size was about 4 x 5 cm in cross. On laboratory examination, diabetic evidence such as high blood sugar (FBS 170 mg/dl, PP2hr. 234 mg/dl) and glucosuria. The CBC finding suggested polycythemia with high hemoglobin (18.0 g/dl) and hematocrit (54%) levels. The differential count and platelet count were within normal limits.

Original Articles

Primary Undifferentiated Carcinoma of the Endometrium with Small Cell and Trophoblastic Differentiation.: Chul Hwan Kim, Seoung Hye Park, In Sun Kim, Seung Yong Paik; Korean J Pathol. 1990;24(1):58-64.

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Abstract PDF: This report describes a very rare case of primary undifferentiated carcinoma of the endometrium with small cell and trophoblastic differentiation. The patient was 54-year-old woman with complaints of vaginal bleeding and palpable lower abdominal mass. The light microscopic findings revealed predominantly small cells with round nuclei, spindle cells, and large cells with hyperchromatic bizarre nuclei. Foci of syncytiotrophoblastic giant cells are scattered, especially in the hemorrhagic areas. Immunohistochemical stainging for neuron specific enolase and beta-hCG showed positive reactions to small cells and syncytiotrophoblastic giant cells, respectively. Argentaffin and argyrophil stains, however, showed negative reactions to small cells. The histogenesis of small cell undifferentiated carcinoma of the endometrium remains unclear; however, it may arise from epithelial precursors instead of neuroendocrine cells, and syncytiotrophoblastic cells may be differentiated or dedifferentiated from the undifferentiated carcinoma cells.

Sex Cord Tumor with Annular Tubules Metastasized to Mesentery.: Yong Koo Park, Jae Hoon Park, Ju Hie Lee, Moon Ho Yang; Korean J Pathol. 1990;24(1):65-69.

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Abstract PDF: The sex cord tumor with annular tubules (SCTAT) is a distinctive ovarian neoplasm of which predominant component has intermediate morphologic features between the granulosa cell tumor and the Sertoli cell tumor; focal differentiation into either granulosa cell or Sertoli cell tumor may occur. We presented a 24-year-old woman with SCTAT metastatic to the mesentery root. The origin of the primary was the left ovary, and the tumor was diagnosed nine years ago. This report dealt with clinical presentation and prognosis.

Case Reports

Carcinoid Tumor of the Uterine Cercix: A light and electron microscopic study of two cases.: Moon Hyang Park, Jung Dal Lee, Yoon Young Hwang; Korean J Pathol. 1990;24(1):70-76.

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Abstract PDF: Two cases of carcinoid tumor of the uterine cervix were reported with emphasis on the histologic, cytologic, histochemical and electron microscopic appearance of tumor cells. Based on the light microscopic findings, one case was a well differentiated carcinoid with acinus formation, and the other was a poorly differentiated anaplastic type, being composed of small cells similar to those of oat cell carcinoma of the lung. Both tumors demonstrated scattered argyrophilic cells on Grimelius stain, and contained neurosecretory granules on electron microscopy. They were in stages II b and IV, respectively, at the time of presentation. The latter patient was treated with vinblastin, platinol and bleomycin, but died in 9 months after the initial diagnosis. The former was lost to follow-up study. Importance of distinction between this highly malignant tumor and other varieties of cervical cancer was emphasized.

Ependymoma Containing Cartilage: A case report.: Eun Kyung Hong, Jung Dal Lee; Korean J Pathol. 1990;24(1):77-81.

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Abstract PDF: The presence of cartilage in a glial tumor is exceptional. It frequently occurs in ependymoma of midline location in young child nuder 5 years of age. The mechanism of cartilage and bone formation in ependymoma is thought to be either metaplastic transformation from mesenchymal tissue or direct transformation from the neoplastic glial cells. A case of ependymoma containing cartilage and bone is reported. The patient is a 4 year-old girl, having calcified mass in the 4the ventricle and cerebellar vermis. The pathogenesis of cartilage formation in this ependymoma is more likely to support the mataplastic theory.

Mucoid Cyst of Penile Skin: A case report.: Joong Seok Seo, Yong Wook Park, Kye Yong Song, Sae Chul Kim; Korean J Pathol. 1990;24(1):82-84.

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Abstract PDF: A rare case of mucoid cyst of the penile skin in a 23 year-old man is reported, which has been presented as a movable, superficial and no tender nodule, measuring 0.8 cm in maximum diameter at the periurethral meatus of the glans for 6 months. This nodule was removed by simple excision and proved to be a mucoid cyst of penile skin, which was lined by pseudostratified columnar epithelium with occasional mucous epithelium and glands, suggesting its origin is most likely from sequestrated periurethral glands.

A Case of Intracranial Malignant Teratoma.: Bong Kwon Chun, Hee Kyung Chang, Man Ha Huh; Korean J Pathol. 1990;24(1):85-90.

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Abstract PDF: The authors report a case of malignant teratoma in a 3-year-old girl who suffered from occipital headache and vomiting for about 2 months. The tumor occupied left cerebellopontine angle resulting in a moderate degree of hydorcephalus. Histologically, the tumor consisted mainly of neuroepithelial tissues showing varying degrees of differentiation, with areas of epidermis, mature fat tissue, connective tissue, gastrointestinal glands and smooth muscle bundles containing ganglions. Also noted are groups pf polygonal or spindle cells representing immature mesodermal tissue. In contrast to two malignant intracranial teratomas previously reported in Korean literatures, this case is characterized by the presence of predominent neuroepithelial components and by uncommon tumor location, the posterior fossa far from middle line of the body.

Original Article

Metastatic Embryonal Carcinoma of Testis: Aspiration Cytology of Cervical Lymph Node.: Jung Weon Shim, Hae Kyung Ahn, Il Hyang Ko; Korean J Pathol. 1990;24(1):91-94.

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Abstract PDF: Embryonal carcinoma of testis may be composed of primitive cells with epithelial appearance showing prominent variation in size and shape, clear cytoplasm, overlapping nuclei. and many mitoses. Multiple lymph node enlargement was noticed in a 45-year-old man with known huge testicular tumor, 20 x 15 cm, and clinically malignant lymphoma was suspected. Microscopic and cytologic finding of both biopsy and needle aspiration from neck lymph node disclosed highly undifferentiated large cells, mostly in solid sheets and often forming glandular spaces. Massive necrosis was observed. Cytologic diagnosis of embryonal carcinoma was made possible, relied on the result of immunohistochemistry that revealed negative LCA, and positive cytokeratin and CEA as well as the cytologic features. Serum levels of HCG and AFP of the patient, in addition, were markedly elevated.

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