Journal of Pathology and Translational Medicine

Brief Case Report

WITHDRAWN:Uterine Arteriovenous Malformation Accompanied with a Uterine Stromomyoma: Yul Ri Chung, Dohee Kwon, Sehui Kim, Hee Young Na, Nayoung Han, Hyo Jin Kim, Min A Kim, In Ae Park; Received May 13, 2016 Accepted September 23, 2016 Published online August 4, 2017; DOI: https://doi.org/10.4132/jptm.2016.09.24

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Case Study

Follicular Proliferative Lesion Arising in Struma Ovarii: Min Jee Park, Min A Kim, Mi Kyung Shin, Hye Sook Min; J Pathol Transl Med. 2015;49(3):262-266. Published online May 15, 2015; DOI: https://doi.org/10.4132/jptm.2015.03.26

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Malignant struma ovarii is extremely rare and difficult to diagnose histologically, particularly in cases of follicular carcinoma. This case study is intended to describe three cases of follicular proliferative lesion arising in struma ovarii that we experienced. The first case was clearly malignant given the clinical picture of multiple recurrences, but there was little histological evidence of malignancy. Our second case featured architectural and cellular atypia and necrosis and was diagnosed as malignant despite the absence of vascular and stromal invasion. Our third case exhibit-ed solid microfollicular proliferation without any definite evidence of malignancy (even the molecular data was negative); however, we could not completely exclude malignant potential after conducting a literature review. In cases such as our third case, it has been previously suggested that a diagnostic term recognizing the low-grade malignant potential, such as “proliferative stromal ovarii” or “follicular proliferative lesion arising in the stromal ovarii” would be appropriate.

Citations

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Role of gene sequencing in classifying struma ovarii: BRAF p.G469A mutation and TERT promoter alterations favour malignant struma ovarii
Sophie Neyrand, Alexis Trecourt, Jonathan Lopez, Pierre Alexandre Just, Françoise Descotes, Françoise Borson‐Chazot, Isabelle Ray‐Coquard, Myriam Decaussin‐Petrucci, Mojgan Devouassoux‐Shisheboran
Histopathology.2024; 84(2): 291. CrossRef
Malignant struma ovarii: next-generation sequencing of six cases revealed Nras, Braf, and Jak3 mutations
Roberta Poli, Maria Scatolini, Enrico Grosso, Francesca Maletta, Marco Gallo, Daniele Liscia, Anna Nelva, Flora Cesario, Giuseppe Forte, Jasna Metovic, Marco Volante, Emanuela Arvat, Mauro Papotti
Endocrine.2021; 71(1): 216. CrossRef
Proliferative struma ovarii: A rare case report
Shankhanila Mazumdar, GaganKumar Rangari, Neeraj Dhameja, NishaRani Agrawal
International Journal of Clinicopathological Correlation.2021; 5(2): 85. CrossRef
Malignant struma ovarii presenting with follicular carcinoma: A case report with molecular analysis
Takafumi Tsukada, Hiroshi Yoshida, Mitsuya Ishikawa, Yuka Asami, Kouya Shiraishi, Tomoyasu Kato
Gynecologic Oncology Reports.2019; 30: 100498. CrossRef
A Rare Case: Struma Ovarii in a 14-Year-Old Girl
Elif Iltar, Isin Ureyen, Tayfun Toptas, Melike Savas, Sema Çekiç, Aysel Uysal
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Proliferative Highly Differentiated Follicular Carcinoma Of Ovarian Origin (Hdfco) Presenting Long After Bilateral Oophorectomy
Natalie M. Liu, Neda Moatamed, Racquel S. Bueno, Wendy L. Sacks
AACE Clinical Case Reports.2017; 3(3): e264. CrossRef

Original Articles

Diagnostic Accuracy of Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology of Pancreatic Lesions: Hae Woon Baek, Min Jee Park, Ye-Young Rhee, Kyoung Bun Lee, Min A Kim, In Ae Park; J Pathol Transl Med. 2015;49(1):52-60. Published online January 15, 2015; DOI: https://doi.org/10.4132/jptm.2014.10.26

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Abstract PDF

Background
Endoscopic ultrasound–guided fine needle aspiration cytology (EUS-FNAC) is currently the most commonly used procedure for obtaining cytologic specimens of the pancreas. It is accurate, minimally invasive, safe and cost-effective. However, there is discrepancy between cytological and surgical diagnoses. This study was aimed at evaluating the diagnostic accuracy of EUS-FNAC of the pancreas. Methods: We performed a retrospective review of 191 cases of pancreatic lesions initially diagnosed by EUS-FNAC with subsequent histological diagnosis between 2010 and 2012 in the Department of Pathology, Seoul National University Hospital. Cytologic and surgical diagnoses were categorized into five groups: negative, benign, atypical, malignant, and insufficient for diagnosis. Subsequently, 167 cases with satisfactory yield in both surgical and cytology specimens were statistically analyzed to determine correlations with diagnosis. Results: In comparison to surgical diagnoses, cytologic diagnoses were true-positive in 103 cases (61.7%), true-negative in 28 cases (16.8%), false-positive in 9 cases (5.4%), and false-negative in 27 cases (16.1%). The diagnostic accuracy was 78.4%, sensitivity was 79.2%, and specificity was 75.7%. The positive predictive value was 92.0%, and negative predictive value was 50.9%. Conclusions: EUS-FNAC has high accuracy, sensitivity, specificity and positive predictive value. Overcoming the limitations of EUS-FNAC will make it a useful and reliable diagnostic tool for accurate evaluation of pancreatic lesions.

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Maroun Bou Zerdan, Malek Shatila, Dhruv Sarwal, Youssef Bouferraa, Morgan Bou Zerdan, Sabine Allam, Merima Ramovic, Stephen Graziano
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Markers for Screening Lynch Syndrome Are Reliable and Useful for Identifying the Specimen Mislabeling: Sun-ju Byeon, Jiwoon Choi, Kyung Han Nam, Bo-Gun Jang, Hee Eun Lee, Min A Kim, Woo Ho Kim; Korean J Pathol. 2012;46(2):131-136. Published online April 25, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.2.131

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Abstract PDF

Background

During specimen processing in surgical pathology laboratories, specimen-related adverse events (SRAEs), such as mislabeling and specimen mixed-up might occur. In these situations, molecular techniques using short tandem repeat (STR) loci are required to identify the personal identity. Microsatellite instability (MSI) test is widely used for screening the hereditary non-polyposis colon cancer (Lynch syndrome) in surgical pathologies using polymorphic STR markers. We tried to evaluate the applicability of the MSI test for SRAEs.

Methods

We obtained 253 MSI test results to analyze the allele frequencies. After calibrating the estimated nucleotide lengths, we calculated the allele frequencies, a random match probability, and a likelihood ratio (LR) of three dinucleotide STR markers (D5S349, D17S250, and D2S123).

Results

The distribution of LR was 136.38 to 5,606,213.10. There was no case of LR<100. In addition, there were 153 cases (60.5%) of LR ranging from 100 to 10,000 and 100 cases (39.5%) of LR>10,000. Furthermore, the combined probability of identity was 9.23×10^-4 and the combined power of exclusion was 0.99908.

Conclusions

Using the three STR markers that are recommended for MSI test, all the cases were positively identified in 1% range and about one-third cases showed high LR (>10,000). These results showed that MSI tests are useful to screen the personal identity in case of SRAE in pathology laboratories.

Citations

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Sensitivity and polymorphism of Bethesda panel markers in Chinese population
Yanying Zheng, Jie Chen, Xiang Zhang, Ling Xie, Yifen Zhang, Yi Sun
Bulletin du Cancer.2020; 107(11): 1091. CrossRef

Short Case Report

Intranodal Palisaded Myofibroblastoma with Desmin Expression : A Brief Case Report.: Dong Chul Kim, Tae Hoon Kang, Min A Kim, Yoon Kyung Jeon; Korean J Pathol. 2009;43(3):263-265.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.3.263

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Abstract PDF: Intranodal palisaded myofibroblastoma is a rare benign mesenchymal neoplasm of the lymph node. It is characterized by intranodal spindle cell proliferation along with amianthoid fibers and prominent hemorrhage. It has been rarely reported in South Korea. We report here on a case of palisaded myofibroblastoma that arose in the left inguinal lymph node. The tumor mass was well demarcated, and it was composed of a proliferation of benign-looking spindle cells. It showed focal hemorrhage and a fibrous pseudocapsule. The tumor cells displayed little pleomorphism, no mitotic count, and characteristic palisading nuclei and amianthoid fibers. The tumor cells were positive for smooth muscle actin, vimentin, and also for desmin, but they were negative for S-100 protein, supporting the diagnosis of myofibroblastoma.

Case Reports

Bronchoalveolar Lavage (BAL) Cytology and Ultrastructural Findings in a Patient with Amiodarone-Induced Pulmonary Toxicity: A Case Report.: Sun Lee, Min A Kim, Young Soo Shim, Chun Taek Lee, Je G Chi, Doo Hyun Chung; Korean J Pathol. 2002;36(3):175-178.

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Abstract PDF: Amiodarone is a potent antiarrhythmic agent and can cause potentially life-threatening pulmonary fibrosis. Of the numerous side effects associated with amiodarone therapy, lugn toxicity is one of the most serious adverse reactions. Recently, we experienced a case of amiodarone-induced pulmonary toxicity (APT), which induced severe dyspnea and productive coughing, confirmed by cytologic and electron microscopic examination of the bronchoalveolar lavage (BAL). The symptoms and abnormalities in the chest X-ray were improved after the withdrawal of amiodarone. Cytologic examination of the BAL revealed numerous foam cells with cytoplasmic vacuoles or small particles. Ultrastructurally, the foam cells demonstrated characteristic lysosomal inclusions, which were electron-dense multilamellated bodies, crystalloid bodies, and mixed forms with small lipid vacuoles. It is strongly suggested that only cytologic and electron microscopic examination of the BAL without open lung biopsy is enough for diagnosis of APT, when APT is clinically suspected in a patient who has a history or ingestation of amiodarone.

Intestinal Metastasis of Osteosarcoma Presenting with Intussusception: A Case Report.: Seong Ho Yoo, Min A Kim, Kyu Joo Park, Joon Koo Han, Sang Hoon Lee, Chong Jai Kim, Eui Keun Ham; Korean J Pathol. 2002;36(4):271-273.

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Abstract PDF: Metastatic osteosarcoma most commonly affects the lungs and other bones. Intestinal intussusception caused by metastatic osteosarcoma is very rare. We report a case of metastatic osteosarcoma of the intestine in a 39-year-old female. She underwent surgical resection of the left femur due to osteosarcoma and received additional chemotherapy 3 years ago. Pulmonary metastasis was found two years later and the patient complained of abdominal pain, nausea and vomiting after 8 months following excision of the lung nodules. Abdominal computed tomography revealed intussusception with a suspected polypoid mass in the distal portion of the jejunum. The histologic findings of the resected bowel were those of osteosarcoma. This is the first case of documented intestinal metastasis of osteosarcoma in Korea. It is suggested that the tumor metastasis to the small intestine should be considered in patients with previous osteosarcoma, when the patient presents with acute abdominal symptoms and intussusception.

Original Article

Comparison of Efficacy of Human Papilloma Virus Genotyping Assays using Restriction Fragment Mass Polymorphism and DNA Chip Analysis in Patients with Abnormal Pap Smear and Uterine Cervical Cancer.: Hyun Jae Chung, Sung Nam Kim, Eun Hee Lee, Mi Sun Jee, Min A Kim, Sun Young Hwang, Hee Jung Cho, Soo Ok Kim, Sun Pyo Hong; Korean J Pathol. 2006;40(6):439-447.

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Abstract PDF: BACKGROUND
High-risk human papilloma virus (HPV) infection is the primary cause of cervical cancer; there is a need for more sensitive and reliable methods for HPV genotyping to use as screening tools for early detection and intervention. METHODS: A novel MALDI-TOF MSbased assay, termed Restriction Fragment Mass Polymorphism (RFMP) was developed for multiple HPV genotyping. Its performance was compared with DNA chip technology. The study was based on 164 cases classified as normal (n=40), ASCUS (n=53) and invasive squamous cell carcinoma (SCC, n=71) by a PAP smear and/or cervical colposcopic biopsy.
RESULTS
High-risk genotypes were detected in 7.5%, 47.2% and 97.2% in normal, ASCUS and SCC groups by RFMP, and in 20.0%, 41.5% and 90.1% using DNA chip technology, respectively. The results showed substantial concordance, with a kappa coefficient of 0.688, between the methods. Diagnostic sensitivity and specificity for cervical cancer were found to be 97.2% and 92.2% with RFMP and 90.1% and 80.0% using DNA chip microarrays.
CONCLUSIONS
RFMP and DNA chip technologies were shown to be reliable methods for HPV genotyping with a high concordance. The improved sensitivity and specificity should make RFMP a viable option for the management of women with cervical neoplastic lesions.

Case Reports

Myxoma of the Ovary with Uncertain Malignant Potential: A Case Report.: Min A Kim, Ji Hoon Kim, Jae Y Ro, Geunghwan Ahn, In Ae Park; Korean J Pathol. 2004;38(6):434-437.

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Abstract PDF: Primary ovarian myxoid tumor such as myxoma, myxoid liposarcoma and myxoid leiomyosarcoma is extremely rare neoplasm. We experienced a case of unusual myxoid tumor of the ovary in a 25 year-old woman. She was admitted for an incidentally found ovarian mass during antenatal check. Radiologic studies revealed a 5.5x5 cm-sized solid mass in left ovary and she was undertaken left oophorectomy. Grossly, the round ovarian mass was measuring 8x6x5 cm, and the cut surface was predominantly solid with myxoid appearance. Microscopically, the tumor was surrounded by thick collagenous capsule and had moderate cellularity and rich vascularity. The tumor cells were stellate-shaped with abundant extracellular myxoid material without atypia. We initially thought this lesion as myxoma, but the cellularity was too high as an ordinary myxoma. Myxoid liposarcoma could also be considered as the differential diagnosis, however there was no convincing lipoblast. So, we diagnosed that tumor as myxoma with uncertain malignant potential.

Dedifferentiated Chondrosarcoma with Giant Cell-rich Sarcomatous Component Resembling Giant Cell Tumor: A Case Report.: Pil Gyu Hwang, Jae Kyung Won, Min A Kim, Han Soo Kim, Sang Hoon Lee, Chong Jai Kim; Korean J Pathol. 2004;38(5):345-349.

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Abstract PDF: Dedifferentiated chondrosarcoma is an uncommon bone tumor, defined as a tumor in which two components -a low-grade chondrosarcoma and a high-grade non-cartilaginous sarcoma-coexist with abrupt interface. We report a rare case of giant-cell rich dedifferentiated chondrosarcoma occurred in the right distal femur shaft of a 60 year-old female. The plain X-ray film showed an irregular radiolucent mass. The T2-weighted MRI revealed a heterogeneous high signal intensity. It was an irregular mass composed of bluish-white, translucent chondroid elements and yellowish solid components with extraosseous invasion. Microscopically, a low-grade chondrosarcoma and a giant-cell rich spindle cell sarcoma with areas resembling giant cell tumor were recognized with abrupt transition. Immunohistochemical staining revealed a S100 protein positivity in chondroid cells and a few spindle cells. CD68 was strongly positive in giant cells. Vimentin was positive in both components and smooth muscle actin was positive in some spindle cells. There was no cytokeratin, desmin and myogenin immunopositivity. It is important to be aware of this rare variant of dedifferentiated chondrosarcoma to avoid the misdiagnosis of more common bone tumors including giant cell tumors.

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