Journal of Pathology and Translational Medicine

Volume 7(1); June 1996

Original Article

Recent Advances in Cancer Diagnosis: On an Overview of Diagnostic Cytopathologic Modalities and Ancillary Techniques.: Kital Kim, Eui Keun; Korean J Cytopathol. 1996;7(1):1-11.

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Abstract PDF: Form the concepts of cellular pathology and of exfoliative cytology, as elucidated by Virchow and Papanicolaou respectively in the late 19th and early 20th century, have evolved the primary methods for the diagnosis of cancer today. From Papanicolaou's concept of exfoliative cytology developed fine needle aspiration biopsy in the early 1960's ; this has become a major diagnostic procedure and has contributed to a significant reduction in open biopsies and, therefore, to medical cost-effectiveness. Immunobiochemical techniques provided us with a supplement to cancer diagnosis in the 1980's. The immunoperoxidase method, using monoclonal antibodies, is applied primarily as an ancillary measure to elucidate the nature of cancers. The evailability of specific monoclonal antibodies has greatly facilitated the identification of cell products or surface markers. For example, antibodies directed against intermediate filaments have proved to be of value in determining the histogenesis of poorly differentiated neoplasms. Tumor markers may serve as biochemical indicators of the presence of a neoplasm. They can be detected in plasma and other body fluids. Their concentration can be applied as a diagnostic test, for monitoring the clinical course of known cancer, and as a screening measure to detect certain cancers in a population at risk. Flow cytometry is a useful tool for distinguishing several cell characteristics. such as the immunophenotype of leukemia-lymphoma cells, the DNA content of neoplastic cells, and cell proliferation rate. Molecular biologic techniques provided a giant step for the management of cancer patients encompassing diagnosis, prognostic evaluation, and therapy. Nucleic acid hybridization techniques are utilized as Southern, Northern, and dot blots and in situ hybridization. Molecular biology and its techniques may bring a bright new horizon for understanding cancer biology and in designing therapy on the basis of gene manipulation

Etc

A Pathologic Study on Tropical Malaria in South Vietnam -Analysis of Cause of Death in 7 Autopsy Cases-: Yong Il Kim, Ki Hong Kim; Korean J Cytopathol. 1973;7(1):1-12.

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Abstract: The pathologic lesions in seven consecutive autopsy cases among 555 Korean army personnel of falciparum malaria, during a period of November 1965 to July 1966, performed at the Oth Evacuation Hospital, ROKA in South Vietnam, were presented and correlated with cause of death. 1. All of the cases were heavily infected with P. falciparum, but one combined with P. malariae as well. Their duration of illness ranged from 7 to 11 days. 2. Basic Pathologic changes in each organ and tissue were related with presence of parasitized red blood cells and malaria pigments with subsequent development of tissue hypoxia and advanced proliferative changes of reticuloendothelial system. 3. Direct cause of death in all of fatal cases was considered to be cerebral. malaria, although cerebral lesions varied and presented no intimate relationship to clinical manifestations ; their findings strongly indicated cerebral hypoxia secondary to capillary blood stasis and plugging of parisitized red blood cells. None of cases demonstrated actual thrombosis or Durck’s glial nodes. 4. Renal lesions, both blackwater fever and malarial nephrosis, were inconspicuous, and did not considered as a direct cause of death ; one case was featured with mild hemoglobinuric nephrosis but giving no significant histologic differences from others. Mesangial changes of renal glomeruli encountered in the others accompanied moderate accentuation of glomerular lobulation, but evidence of malarial nephrosis remained unclarified. 5. Myocardial changes occurred with relative frequency, revealing focal necrosis together with interstitial edema, to result in acute myocardial insufficiency and pulmonary edema in one. 6. Presence of fibrin thrombi, though rarely manifest, raised possibility of intravascular coagulation as one of hemorrhagic diathetic mechanisms in fatal malarial infection.

Original Article

Role of Cytologic Scoring System in Minimizing "Gray Zone" in Breast Aspiration Cytology.: Jung Yeon Kim, Kyung Ja Cho, Seung Sook Lee, Shin Kwang Khang; Korean J Cytopathol. 1996;7(1):12-22.

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Abstract PDF: Fine needle aspiration(FNA) has been quite successful in identifying benign and malignant breast lesions, but a "gray zone" exists. A total of 697 FNAs of breast were performed at Korea Cancer Center Hospital for a period of one year. One hundred and eleven of the 697 FNAs were diagnosed as atypical or suspicious for malignancy. Among them, we reviewed 74 FNAs, in which histologic diagnoses were made, and applied cytologic grading system proposed by masood et al.(1990) to evaluate the usefulness of this system in minimizing the size of gray zone. Technical problem was responsible for equivocal diagnoses in 19 FNAs. Of the remaining 55 FNAs, 18 were benign and 37 were mali. Among benign conditions, fibroadenoma(5 cases) and fibrocystic disease with fibroadenomatous feature(3 cases) constituted the largest groups. The majority of malignant conditions were infiltrating ductal carcinoma(29 cases); however, those low grade carcinomas including tubular carcinoma(3 cases), cribriform carcinoma(2 cases), and mucinous carcinoma(2 cases) occupied a relatively large proportion Cytologic grading system was quite useful in minimizing the size of gray zone. The scores of 27 out of 29 usual infiltrating ductal carcinomas belonged to the group of cytologic malignancy, however, only 2 out of 7 low grade carcinomas got scores of malignancy. FNA from fibroadenoma or fibrocystic disease with fibroadenomatous features showed a tendency toward high scores. Experience of the cytopathologist and famillarity with cytologic alteration in breast disease cannot be overemphalized.

Etc

Clinical, Histopathological and Studies on Malignant Lymphomas among Koreans: Kwang Kil Lee, Yoo Bock Lee, Dong Sik Kim; Korean J Cytopathol. 1973;7(1):13-28.

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Abstract: The malignant lymphoma is a malignant proliferation of the reticuloendothelial and lymphoid elements that are found in lymphnodes and other lymphoid tissues of spleen, tonsil, small intestine, etc. The clinical picture of this malignant disorder is sometimes so variable, and causes of lymphnode enlargement are so many that the lymphoma has been taken a much importance both clinically and pathologically. Many authors have reported and discussed about the so-called pseudolymphomatous lymphadenitis (Saltzstein, 1958 ; Canale and Smith, 1967 ; Hartsock, 1968 ; Rosai and Dorfman, 1969), viral lymphadenitis (Salvador et at., 1971) and marked follicular hyperplasia of lymphnodes (Evans, 1944 ; Motulsky et al., 1952 : Stansfeld, 1961) which resemble the malignant lymphoma histopathologically, and in fact, early lymphocytic lymphomas, early Hodgkin’s disease, mild inflammatory reactions and reticular hyperplasias may be difficult or impossible to distinguish from one another (Willis, 1967) in spite of diligent research of pathologists in that field. The classification of the lymphomas has undergone a series of changes over the years, and now the one proposed by Rappaport et al. (1956) is widely used as the classification of Lukes et al. (1966) for Hodgkin’s disease. There are several reports on lymphoma among Koreans based on clinical aspects but there are very little reports on lymphomas based on pathological aspects, especially the ones which are classified by the Rappaport et al.’s and Lukes et al.’s. The present study is an attempt to investigate mainly histopathological characteristics, such as classification of malignant lymphoma, relationship between histological types of lymphoma, sex, age and location, and to research differential criteria to distinguish the benign lesions from lymphoma of lymphnodes by way of special staining. Materials and Methods ; The materials used in this study consist of 286 cases of malignant lymphoma for 12 years and 8 months from January, 1960 to August, 1972, and 37 cases of benign lesions of the lymphnode. All specimens were fixed in 10% neutral formalin, paraffin embedded blocks were cut in 5 micron thickness, and sections were stained by hematoxylin-eosin methods, and according to the classification of Rappaport et al, (1956) and Lukes et al. (1966), histopathological studies were done on all cases of lymphoma. In addition, methyl-green pyronin and Gomori’s silver impregnation methods were performed on the 37 cases of benign lesion and 81 cases of lymphoma of lymphnodes to observe the number of plasms cells and the amount and distributed pattern of reticulin fibers in them. For all cases of malignant lymphoma whose clinical records were available, sex, age, chief complaints, duration of disease and hematologic data were reviewed.
Results
and Summary ; Clinical and histopathological studies were made on 286 cases of lymphoma, and histochemical studies were performed on 118 cases of excised lymphnodes (benign lesions, 37 ; malignant lymphomas, 81) that were submitted to the Department of Pathology, Yonsei University College of Medicine, during the period of 12 years and 8 months from January, 1960 to August, 1972. 1. The histological types in order of frequency were as follows : reticulum cell sarcoma (53.9%), lymphocytic lymphoma (20.3%), lymphoma, mixed cell type (13.6%), Hodgkin’s disease (10.1%) and undetermined (2.1%). 2. The histological types of Hodgkin’s disease in order of frequency were as follows : reticular (48.3%), mixed cellularity (27.6%), lymphocytic and/or histiocytic (13.8%), diffuse fibrosis (6.9%) and nodular sclerosis (3.4%). 3. Among 286 cases, 195 cases (68.2%) were male and 91 cases (31.8%) were female. The average age was 37.1 year-old (male : 33.9 years, female 44.9 years). 4. Clinical symptoms in order of frequency were as follows : enlargement of the lymphnode or palpable mass (75.2%), local pain (34.3%), gastrointestinal symptoms (21. 2%) and ENT symptoms (14.6%). The duration of chief complaints was mostly within 6 months (78.2%). 5. The locations of malignant lymphomas were as follows : nodal, 143 cases (50.5%) and extranodal, 124 cases (43.4%). Among the nodal group, cervical area was the most common (81.1%), and the next, axillary (21.7%) and inguinal (10,3%). Among the extra-nodal group, nasopharynx was the most common (27.4%), and the next, tonsil (25.8%) and small intestine (16.9% ) 6. Hodgkin’s disease showed somewhat bimodal curve in age distribution, was more common in male than other types of lymphoma, and involved gastrointestinal tract most commonly when extranodal in its origin. 7 Except cases of Hodgkin’s disease, the more the number of plasma cells in lymphnodes, the more likely the lesion was benign but this was not an absolute criterion in deciding the nature of lesions. 8. The amount and distribution pattern of reticulin fibers in lymphnodes gave a considerable aid in some cases to distinguish between benign and malignant but these did not have a great significance in deciding the nature of lesions. In conclusion based on these findings, it can be stated that reticulum cell sarcomas are more common and Hodgkin’s disease are less common in this country than in western countries. The existing number of plasma cells and the amount and distribution of reticulin fibers could be considerable aid in deciding the nature of lesions of lymphnodes, but could not be the decisive factor.

Original Articles

A study of Digital Image Analysis of Chromatin Texture for Discrimination of Thyroid Neoplastic Cells.: Sang Woo Juhng, Jae Hyuk Lee, Eun Kyung Bum, Chang Won Kim; Korean J Cytopathol. 1996;7(1):23-30.

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Abstract PDF: Chromatin texture, which partly reflects nuclear organization, is evolving as an important parameter indicating cell activation or transformation. In this study, chromatin pattern was evaluated by image analysis of the electron micrographs of follicular and papillary carcinoma cells of the thyroid gland and tested for discrimination of the two neoplasms. Digital grey images were converted from the electron micrographs; nuclear images, excluding nucleolus and intranuclear cytoplasmic inclusions, were obtained by segmentation; grey levels were standardized; and grey level histograms were generated. The histograms in follicular carcinoma showed Gaussian or near-Gaussian distribution and had a single peak, whereas those in papillary carcinoma had two peaks(bimodal), one at the black zone and the other at the white zone. In papillary carcinoma. the peak in the black zone represented an increased amount of heterochromatin particles and that at the white zone represented decreased electron density of euchromatin or nuclear matrix. These results indicate that the nuclei of follicular and papillary carcinoma cells differ intheir chromatin pattern and the difference may be due to decondensed chromatin and/or matrix substances.

Cytologic Features of Renal Cell Carcinoma: Clear Cell, Granular Cell and Oncocytoma.: Yeong Jin Choi, Youn Soo Lee, Mi Seon Kwon, Kyo Young Lee, Byung Kee Kim, Sang In Shim; Korean J Cytopathol. 1996;7(1):31-37.

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Abstract PDF: It is well known that fine needle aspiration biopsy(FNAB) is very useful and has a high accuracy rate in the diagnosis of renal neoplasms. Although there is some indecision to perform the FNAB for a rare possibility of tumor seeding along the biopsy needle tract, it tends to be used increasingly. As in the cytologic diagnosis of metastatic lesion through out the body, renal cell carcinoma should nearly always be considered in the differential diagnosis, the precise understainding of cytologic features of renal cell carcinoma with various cell types and architectural patterns is necessarily required. In this report, we present three cases of primary renal cell tumors, two of renal cell carcinomas and one of oncocytoma, preponderantly emphasizing the cytologic differential points in the FNAB specimen.

Etc

Clinical and Histopathological Studies on Surgical Thyroid Diseases Among Koreans: Sung Chong Yim, Chi Whan Kim, Yoo Bock Lee, Dong Sik Kim; Korean J Cytopathol. 1973;7(1):31-46.

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Abstract: Diseases of the thyroid gland are manifested by either increase in gland size, alterations in hormonal secretion, or both. Changes in gland size and weight are associated with toxic or nontoxic goiter, adenomas, thyroiditis, or malignancies. Most of thyroid disease are manifested by mass, local compression in the neck and symptoms arising from disturbances in hormonogenesis resulting in hypothyroidism or hyperthyroidism. Also thyroid cancer has nodule and therefore is easily confused as to how to differenciate from other thyroid disease. So that, the thyroid cancer is one of the most debated of all neoplasms in terms of biology, the course and growth, precancerous lesions, surgical treatment and prognosis related to histopathological type. Multiple reports can be found to support almost any thyroid diseases related to malignancy, frequency, etiological factors, age distribution, prognosis and surgical treatment, etc. There are several reports on thyroid disease including cancer among Koreans based on clinical and statistical aspects, but there is no report of thyroid disease based on histopathological aspects in Korea. The present studies have surveyed the records of patients with thyroid disorders seen at Severance Hospital from 1960 to 1971. The incidence and pathological classification of all thyroid diseases among Koreans were investigated, and comparison with pathological diagnosis and clinical diagnosis, the incidence of malignancy in cold nodules of scanning, relationship between the malignancy and lymphocytic infiltration and calcification were observed. Materials and Methods ; The materials used in this study consist of surgically resected thyroid tissues for 12 years from 1960 to 1971. All specimens were fixed in 10% formalin. Grossly, the location and size of the tumor were examined. For histologic examinations, paraffin embedded blocks were cut in 5-6u thickness and sections were stained by hematoxylin eosin method. Histopathological studies on all thyroid diseases are performed as follows : 1. Histopathological classification of Thyroiditis by Hazard (1955). Goiter by Robbins (1967). Adenoma by Meissner and McManus (1953). Carcinoma by Hare and Salzman (1950). 2. Functional status. 3. Lymphocytic infiltration and calcification. For the all cases of thyroid diseases whose clinical records were available, sex, age, chief complaints, duration, location and size of lump, clinical diagnosis. type of treatment were reviewed.
Results
and Summary ; Clinical and histopathological studies were made on 446 surgically removed tissues of thyroid lesions, that were submitted to the department of pathology, Yonsei University College of Medicine, during the period of 12 years from 1960 to 1971. The following results were obtained. 1. Among 446 cases, 397 cases were female and the ratio of male and female thyroid disease was 1 : 8.1. In all cases observed, 199 cases (43.3%) adenoma, 130 cases (29.1%) goiter, 193 cases (20.9%) carcinoma, 24 cases (5.4%) thyroiditis were included. 2. The average age of adenoma was 34.2 year-old, nontoxic goiter 37.2, toxic goiter 37.8, carcinoma 41.2, thyroiditis 44.6. 3. The most common complaints of thyroid diseases was a mass(94.2%). The other clinical symptoms in order of frequency were palpitation, dyspnea and cough etc. 4. The average duration of chief complaint of thyroid carcinoma was 4.0 years, adenoma 3.5 years, goiter 1.9 years and thyroiditis 3. 1 years. 5. The comparison of the size of adenoma with that of carcinoma was not significantly different. The average size of adenoma was 4.6 cm and carcinoma 4.7 cm. 6. Among 28 cases of scanning, 18 cases (64.3%) were cold nodule in which 11 cases were adenoma in pathological diagnosis. 7. Some of clinical diagnosis was different from pathological diagnosis. Correct diagnosis of carcinoma was 35.1%, adenoma 31.9%, goiter 80.0% and thyroiditis 6.7%. 8. Histopathologically all of thyroiditis were chronic thyroiditis except one case that was acute suppurative thyroiditis. Hashimoto’s thyroiditis was 50% of all chronic thyroiditis. 9. Histopathologically nontoxic goiter comprises about 76.2% of all goiters. Nontoxic nodular goiter is 70.8% of all goiters. 10. Histologically follicular type comprises about 93% of adenoma. Most of follicular type consist of fetal type (37.8%) and colloid type (37.3%). 11. Histologically, papillary carcinoma is 60.2% of all carcinoma. There is no relation between type of thyroid carcinoma and lymphocytic infiltration. Among 76 cases with papillary growth carcinoma, calcification was observed in 38 cases (50%).

Original Articles

Application of Epstein-Barr Virus Cell Lines (CCL85 EB-3) in Performing the EBER mRNA In Situ Hybridization as a Positive Control.: Sung Sook Kim, Woon Sup Han, Joo Young Suh, Joo Ryung Huh; Korean J Cytopathol. 1996;7(1):38-43.

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Abstract PDF: Epstein-Barr virus(EBV) is associated with a wide spectrum of benign and malignant disorders including leukoplakia, Hodgkin's lymphoma, central nervous system lymphoma, peripheral T cell lymphoma and nasopharyngeal undifferentiated carcinoma. There are several distinctive aspects of biology of the virus that are important in investigation of virus in clinical specimens. The abundant expression of the EBER mRNA transcripts makes possible the sensitive detection of latent expression in EBV-associated tumors. Although there has been a dramatic increased interest in the direct characterization of EBV in clinical specimens, there have been few studies about the effective and reliable positive controls in performing in situ hybridization technique for EBV, especially on paraffin-embedded tissue. We applied Burkitts lymphoma cell line as positive control in EBV in hydridization using Oncor Kit. The cell block of Burkitt lymphoma cell line(CCL85 EB-3) showed strong and specific positivity for EBER in situ in nuclei of EBV infected cells.

Fine Needle Aspiration Cytology of Metastatic Cell Carcinoma of Lymph Nodes: Comparison to Non-Hodgkin's Lymphoma on 5 Cases.: Yeon Mee Kim, Hye Je Cho, Ill Hyang Ko; Korean J Cytopathol. 1996;7(1):44-50.

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Abstract PDF: Small cell carcinoma of the lung is characterized by cells with finely stippled chromatin and scanty cytoplasm as well as a particularly aggressive clinical course and favorable response to the chemotherapy. Recently percutaneous fine needle aspiration(FNA) biopsy has become both widely established and highly respected for the diagnosis of lung cancer. However metastatic small cell carcinoma of lymph node should be cytologically differentiated from the small round cell tumor of particular sites, especially malignant lymphoma, because small cell carcinoma of classic oat cell type may simulate small cell non-Hodgkin's lymphoma. We report five cases of metastatic small cell carcinoma of intermediate cell type diagnosed by FNA of the enlarged lymph nodes of the neck and axilla. The cytologic smears contained diffuse small neoplastic cells larger than lymphocytes with dense, pyknotic nuclei and extremely scanty cytoplasm. Apparently viable large tumor cells have vesicular nuclei with granular, sometimes very coarse chromatin. The characteristic cytologic features of small cell carcinoma as compared to malignant lymphoma were as follows.: 1) small cells with dense pyknotic nuclei are evenly distributed in the background of apparently viable larger tumor cells, admixed with mature lymphocytes and phagocytic macrophages. 2) small loose aggregates of cells with nuclear molding are indicative of small cell carcinoma rather than non-Hodgkin's lymphoma. 3) the cytoplasmic and nuclear fragments of tumor necrosis are more dominant in the smears of small cell carcinoma. 4) nuclear membrane and nucleoli are generally indistinct in small cell carcinoma due to condensation of chromatin.

Etc

Clinical and Histopathological Studies on Tumors of the Small and Large Intestine among Koreans: Woon Sup Han, Yoo Bock Lee, Dong Sik Kim; Korean J Cytopathol. 1973;7(1):47-62.

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Abstract: The tumors of the small and large intestine have been investigated by many workers in both clinical and pathological aspects. It is of interest that although the small bowel comprises the longest portion of the alimentary canal primary tumors in the small bowel are rare (Botsford and Seibel, 1947 ; Darling and Welch, 1959). However, among the tumors of the small bowel, malignancy is more common than benign tumor, and the former consists of adenocarcinoma, lymphosarcoma, carcinoids, etc. The carcinoma of the large intestine in the most frequent malignant tumor throughout the gastrointestinal tract in the U.S.A. But the incidence of this tumor was preceded by the carcinoma of the stomach in Korea(Lee et al., 1965 ; Kim, et al., 1967). The incidence of carcinoma of the colon and rectum in the Asian and African countries is less high than that of the Europe and America(Burkitt, 1971). Carcinoma of the large bowel occures mostly in the 5th and 6th decade of life. In the right colon carcinoma grows as fungating mass, while the distal colon shows "napkin-ring" configuration. The prognosis of a patient with cancer of the large bowel is dependent upon the progess made by that lesion up to the time of operation. The spread may occur through the lymphatics, by direct extension and by the blood stream. Dukes (1932) devided his cases of carcinoma of the rectum into three groups : Type A ; limited to the rectal wall without nodal involvement Type B ; penetrating through bowel wall into adjacent tissue without nodal involvement. Type C ; penetrating through bowel wall with nodal involvement. This classification by Dukes has been adopted as a useful prognostic guide in dealing with carcinoma of the large bowel, and its modifications were also reported. The polypoid lesions of the large bowel can be identified to be adenomatous polyp, villous adenoma, etc. The adenomatous polyp is almost always benign, the incidence of malignancy being less than 1 per cent. Villous adenoma is premalignant, the incidence of malignancy varying from 5 to ,50 per cent, depending upon the series quoted. But some investigators suggested that these two lesions were growth variants of the same tumor (Hellurg, 1963 ; Hertz, et al., ; Ross and Ferrara) There are several reports on carcinoma of the colon and rectum in Korea, which based on clinical and statistical aspects. The present study is attempt to investigate mainly histopathological characteristics and to compare with reports of other countries, and extent to tumors of the small bowel as well as those of the large intestine. Material and Methods ; The material used in this study consists of 408 surgically resected or biopsied tissue from tumors of the large and small bowel for 12 years from 1960 to 1971. At first gross examination was made to observe size, location and growing characteristics of tumors. Regional lymphnodes were dissected and obtained as possible as we could. All specimens were fixed in 10% formalin. For histological examinations, paraffin embedded blocks were cut in 6 micron thickness and sections were stained by routine hematoxylin-eosin method. Histopathological studies on the cases available for microscopic examination are performed as follows : 1. histopathological grading of carcinoma of the large bowel according to the Broders grade (1925) except the mucoid carcinoma was made ; 2. The grades were compared with metastasis to regional lymphnodes of carcinoma of the large intestine and also with venous or lymphatic invasion by carcinoma of the large bowel. ; 3. The carcinoma of the large bowel were classified as the Dukes’classification and stagings by Smith’s method were also made, and then they were made a comparison in relation to each grade of carcinoma. ; 4. The influences of size of carcinoma of the colon and rectum on metastasis to the regional lymphnodes ; 5. The influences of the growing pattern of the tumor margin, infiltrating or pushing, on metastasis to the regional lymphnodes ; 6. The tumors of the small bowel devided into benign and malignant tumors with location of the tumor. At the duodenum carcinomas arising from the ampullar of Vater were included in this study ; 7. The benign tumors of the large bowel also were classified in histopathological findings and associated malignant change was considered in the polyp. For the all cases which clinical redords were available, sex, age, chief complaints, duration of symptom and value of the serum hemoglobin were reviewed. The duration of recurrent carcinoma, of the large bowel was studied in relation to the staging in which readmissions for the treatment of 5-F. U. were not included.
Results
and Summary ; Clinical and histopathological studies were made on 408 surgically removed cases of tumors of the small and large intestine that were submitted to the Department of Pathology, Yonsei University College of Medicine, during the period of 12 years from 1960 to 1971. 1. Among 41 cases of tumors of the small intestine, 37 cases were malignant tumors and the ratio of malignancy and benignancy was 9.5 : 1. 2. Peutz-Jeghers syndrome was found in benign tumors of the small bowel. The malignant tumors of the small intestine consisted of 11 cases of adenocarcinoma, 16 cases of lymphoma, 2 cases of carcinoid, 1 case of undifferentiated carcinoma and 7 cases of metastatic malignant tumors. 3. The lymphoma occurred at the ileum in total 10 cases. The carcinoids throughout the large and small intestine had its origin in extraappendiceal areas, and it showed difference from the reports of the foreign countries. 4. The ratio of the benign tumors and malignant tumors in the large intestine was 1 : 4.8. And also the ratio of the malignant tumors of the large bowel and those of the small bowel was 8.3 : 1. 5. The adenomatous polyps occupied 85.9% of the benign tumors of the large intestine and 93.7% of them occurred at the rectum. The 34 cases of the benign polypoid lesions of the large intestine were less than that of 1.5cm in its diameter. 6. The malignant tumors of the large intestine were 4.3% of the total malignancy of surgical specimens for the same period. 7. Carcinoma of the large intestine showed different clinical symptoms according to the location. 8. The size of carcinoma of the large bowel had no much influence on the metastasis of the regional lymphnodes. 9. The grade of carcinoma of the large intestine had much effects on the venous or lymphatic invasion by carcinoma and also metastasis of the regional lymphnodes. 10. Stage 0 was not identified in the cases examined and the higher the stage of carcinoma of the large intestine was, the higher the grade was. 11. The characteristics of local spread of carcinoma, infiltrating margin or pushing margin, gave much effects on the metastasis to the regional lymphnodes. 12. The tendency was seen that the recurrent period in less advanced stage of carcinoma was a little short, compared with more advanced atage. In conclusions. based on above findings it can be stated that it is important to observe venous or lymphatic invasion by carcinoma, metastasis of the regional lymphnodes and to make stage of the patient of carcinoma in the large bowel. In this study the carcinoma of the large bowel showed relatively advanced stage, and among the tumors of the small intestine the carcinoid had different location from that reported at foreign countries.

Original Articles

Fine Needle Aspiration Cytology of Ovarian Cysts.: In Ae Park, Eui Keun Ham; Korean J Cytopathol. 1996;7(1):51-58.

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Abstract PDF: The cytologic samples of 26 ovarian cystic lesions from 25 women, aspirated under guide by trans-vaginal ultrasound, were evaluated for clinicopathologic correlation. Clinically 20 women were seeking medical assistance for infertility problems, and trans-vaginal cyst aspiration was done during follow-up of ovulation induction. Among them seven cases were histologically confirmed. Twenty cases of "benign cyst" in cytologic diagnosis were follicullar cyst and two cases of "endometriotic cyst" in cytology were histologically also proven in one case. One false positive diagnosis was given to corpus luteum cyst. It is emphasized that because the cysts are aspirated transvaginally and mature squamous epithelial cells occasionally could be mixed in the asmple, attention should be given not to diagnose such cases as mature cystic teratoma. According to this study, ovarian aspiration cytology is useful in the management of cystic ovarian lesions, particularly in young women.

Fine Needle Aspiration Cytology of Sparganosis.: Sung Suk Paeng, Yoon Ju Kim, Seong Eun Yang, Hee Jin Chang, Jung Il Suh, Young Chun Moon; Korean J Cytopathol. 1996;7(1):59-63.

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Abstract PDF: Human sparganosis is a rare parasitic disease in which the larval cestode proliferates in the various organs in the body. It usually presents as a subcutaneous or soft- tissue mass. By fine needle aspiration this lesion can be diagnosed with its characteristic cytologic findings. We experienced 3 cases of sparganosis diagnosed by the fine needle aspiration. Aspirates were taken from subcutaneous mass in the abdomen and both thighs respectively. The aspirates showed a portion of body of sparganum with numerous calcospherules, smooth muscles and tegmentat cells. They also revealed granulomas with various inflammatory infiltration of eosinophils, neutrophils, lymphocytes and plasma cells.

Etc

The Effect of Cortisone on Transformation of Sensitized Allogenic Rabbit Thoracic Lymphocytes in Diffusion Chamber: Bon Young Koo, Sung Kyu Choen, Je Sun Kim; Korean J Cytopathol. 1973;7(1):63-69.

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Abstract: The method of diffusion chamber cultivation was found to be appropriate to observe the potentialities of lymphocytes (Schelton & Rice, 1959 ; Schooley & Berman, 1960 ; Holub, 1958, 1960, 1962), The possibility of separating practically pure suspensions of small thoracic duct lymphocytes enabled us to observe directly the nature of these cells. Holub confirmed that the small lymphocytes from rabbit thoracic duct lymph cells were found capable of being changed to antibody-producing plasmacytoid cells morphologically and functionally when homotransplanted either with or without protein antigen. Bai & Kim (1972) observed the effect of cortisone on the transformation of autologous small lymphocyte of rabbit in diffusion chamber inserted intraperitoneally and confirmed that there was transformation of small lymphocyte into blastic form. Park and Kim (1972) reported allogeneic thoracic lymphocytes in diffusion chamber in cortisone treated rabbits were transformed to blastic form. We made an attempt to observe the effect of cortisone on transformation of eggalbumin sensitized allogeneic rabbit thoracic lymphocyte in diffusion chamber following resensitization. The results were as follows : Sensitized allogeneic thoracic lymphocytes in diffusion chamber were decreased in total number following challenge either by means of intraperitoneal injection or local administration of the same antigen respectively, and/or following those treatment plus injection of cortisone. The transformations into blastic forms were prominent only of the lymphocytes in the challenged group by means of intraperitoneal injection of the same antigen.

Case Reports

Cytologic Findings of Epithelial-Myoepithelial Carcinoma of the Salivary Gland: A Case Report.: Eun Sook Nam, Gu Kang, Hyung Sik Shin; Korean J Cytopathol. 1996;7(1):64-68.

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Abstract PDF: The report of aspiration cytologic findings of epithelial-myoepithelial carcinoma(EMC) in the salivary gland is extremely rare. We present a case of fine needle aspiration cytology(FNAC) from EMC in the right submandibular gland of a 46 years old male patient. Neck CT scan revealed a confined lesion in the submandibular gland without enlargement of the regional lymph node. FNAC from the tumor showed several three-dimensional cellular clusters with admixed normal acinar cells. They frequently formed branching tubular structures composed of two type of cells; darker cells having eosinophilic scanty cytoplasm with round dense nuclei and clear cells having abudant pale cytoplasm with vesicular nuclei at the periphery of clusters. The tumor cells of both types did not show pleomorphism or mitoses. The resected submandibular gland showed an ill-defined whitish firm tumor, measuring 2 X1.5X2cm. The histology revealed an infiltrative tumor showing characteristic two cell types in a duct-like arrangement surrounded by thin basement menbrane. An inner layer of darker cells and outer layer of clear cells were postive for cytokeratin in the former and S-100 protein in the latter on the immunohistochemical stain.

Extrarenal Malignant Rhabdoid tumor: A Case Report.: Sang Yong Lee, Dae Cheol Kim, Seo Hee Rha, Sook Hee Hong, Tae Hun Kang, Young Ho Lee, Kyoung Jin Nam, Jin Sook Jeong; Korean J Cytopathol. 1996;7(1):69-74.

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Abstract PDF: Malignant rhabdoid tumor is a distinct renal tumor in the pediatric age group. It was originally described as a rhabdomyosarcomatoid variant of Wilms tumor. However, subsequent studies failed to confirm myogenous differentiation, so it is now considered to be a distinct and unique type of highly malignant tumor, histogenetically unrelated. Although extrarenal forms of this tumor are rare, several examples have been described in other sites, especially the liver, prostate, paravertebral area, urinary bladder and soft tissue. We experienced a case of malignant rhabdiod tumor located in the intraabdominal cavity in a 10 month-old boy. Smear of peritoneal fluid showed round, polygonal and irregular shaped cells with large nuclei, ample cytoplasm containing Jight pink "to purple cytoplasmic inclusions, and one or a few prominent nucleoli. Immunocytochemistry revealed positivity to cytokeratin, epithelial membrane antigen and vimentin, and negativity to desmin and neuron-specific enolase. These distinct cytologic appearance and immunophenotypes were most consistent with a diagnosis of extrarenal malignant rhabdoid tumor. The cytoplasmic inclusions were correlated with eosinophilic inclusions seen in histologic section and electron microscopy confirmed this interpretation, showing filamentous aggregations in the cytoplasms of the tumor cells.

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