Journal of Pathology and Translational Medicine

Hye Seung Han

20 Articles

Prognostic Implication of Programmed Death-1-Positive Tumor-infiltrating Lymphocytes in Diffuse Large B-Cell Lymphoma.: Young Sin Ko, Young Ha Oh, Chan Kum Park, Wook Youn Kim, Hye Seung Han, So Dug Lim, Tae Sook Hwang, Wan Seop Kim; Korean J Pathol. 2011;45(6):573-581.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.6.573

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BACKGROUND
Programmed death-1 (PD-1) is physiologically expressed by germinal center-associated helper T-cells and has an inhibitory effect on T-cell activity.
METHODS
We examined 63 cases of diffuse large B-cell lymphoma (DLBCL) and determined the number of PD-1-positive helper T-cells in a representative tumor area after immunohistochemical staining using a monoclonal antibody against PD-1. The PD-1-positive cells were counted in 3 high-power fields (HPFs; 400x).
RESULTS
Patients were divided into 2 groups: one with a high number of PD-1-positive cells (>20/HPF, n=33) and one with a low number of PD-1-positive cells (< or =20/HPF, n=30). The former group showed decreased overall survival, but at a statistically non-significant level (p=0.073). A high number of PD-1-positive cells was more common in patients at an advanced clinical stage and with high international prognostic index score (p=0.025 and p=0.026, respectively). The number of extranodal sites also somewhat correlated with the PD-1 staining status (p=0.071). However, the number of PD-1-positive cells was not associated with patient age, serum lactate dehydrogenase level, and Eastern Cooperative Oncology Group performance score.
CONCLUSIONS
The high number of PD-1-positive cells might be associated with an unfavorable outcome in DLBCL patients.

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Mechanisms of PD-1/PD-L1 expression and prognostic relevance in non-Hodgkin lymphoma: a summary of immunohistochemical studies
Pauline Gravelle, Barbara Burroni, Sarah Péricart, Cédric Rossi, Christine Bezombes, Marie Tosolini, Diane Damotte, Pierre Brousset, Jean-Jacques Fournié, Camille Laurent
Oncotarget.2017; 8(27): 44960. CrossRef
Expression of programmed cell death ligand 1 (PD-L1) in advanced stage EBV-associated extranodal NK/T cell lymphoma is associated with better prognosis
Wook Youn Kim, Ho Young Jung, Soo Jeong Nam, Tae Min Kim, Dae Seog Heo, Chul-Woo Kim, Yoon Kyung Jeon
Virchows Archiv.2016; 469(5): 581. CrossRef

Clinical Usefulness of SurePath(TM) Liquid-based Cytology in Thyroid Fine Needle Aspiration: Comparison with the Conventional Smear in Diagnostic Efficacy and Applicability of BRAF Mutation Test.: Wook Youn Kim, Sang Hwa Lee, Young Sin Ko, So Dug Lim, Wan Seop Kim, Hye Seung Han, Hye Sil Seol, Seo Young Oh, Won Jin Moon, Tae Sook Hwang; Korean J Pathol. 2011;45(2):188-195.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.2.188

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Abstract PDF

BACKGROUND
Recently, liquid-based cytology (LBC) has been introduced as an alternative to the conventional smear (CS) technique in thyroid fine needle aspiration, due to its diagnostic convenience.
METHODS
We assessed 77 cases of thyroid fine needle aspiration using the SurePath(TM) method (SP) as LBC and CS via split-sample techniques. BRAF mutation tests were carried out via polymerase chain reaction and pyrosequencing immediately after diagnosis or a delay of more than one year.
RESULTS
In a comparison between SP and CS, the rate of concordance between SP and CS was as high as 84.4% (kappa value, 0.754). In comparison with histologic diagnosis, the overall sensitivity was 100% for both. The specificity was 62.5% for SP and 56.3% for CS. Relative to CS, papillary carcinomas on SP slides revealed more accentuated nuclear irregularities, nucleoli, and reduced nuclear size. In contrast to CS, the delayed BRAFV600E mutation test using SP slides after 1-2 years failed. The use of new primers amplifying shorter product size could help the delayed test achieve success.
CONCLUSIONS
Differences in the diagnostic efficacy of SP and CS were negligible. The failure of the delayed BRAF mutation test on the SP slides might be associated with DNA degradation.

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Comparison of Liquid-Based Preparations with Conventional Smears in Thyroid Fine-Needle Aspirates: A Systematic Review and Meta-Analysis
Yun Jin Kang, Hyeon Woo Lee, Gulnaz Stybayeva, Se Hwan Hwang
Cancers.2024; 16(4): 751. CrossRef
Liquid‐based cytology of pigmented phaeohyphomycotic lesion of the palm masquerading as a metastatic tumor
Thara Keloth, Debasis Gochhait, S Sivaranjani, Neelaiah Siddaraju
Diagnostic Cytopathology.2019; 47(8): 828. CrossRef
DNA degradation in liquid‐based cytology and its comparison with conventional smear
Wook Youn Kim, Seo Young Oh, Hyunkyung Kim, Tae Sook Hwang
Diagnostic Cytopathology.2016; 44(5): 450. CrossRef
Comparison of EASYPREP® and SurePath® in thyroid fine‐needle aspiration
Yosep Chong, Ki Hyun Baek, Jee Young Kim, Tae‐Jung Kim, Eun Jung Lee, Chang Suk Kang
Diagnostic Cytopathology.2016; 44(4): 283. CrossRef
Conventional smears versus liquid-based preparations for thyroid fine-needle aspirates: a systematic review and meta-analysis
Neeraja Nagarajan, Alireza Najafian, Eric B. Schneider, Martha A. Zeiger, Matthew T. Olson
Journal of the American Society of Cytopathology.2015; 4(5): 253. CrossRef
Liquid‐based cytology improves preoperative diagnostic accuracy of the tall cell variant of papillary thyroid carcinoma
Sung Hak Lee, Chan Kwon Jung, Ja Seong Bae, So Lyung Jung, Yeong Jin Choi, Chang Suk Kang
Diagnostic Cytopathology.2014; 42(1): 11. CrossRef
Stability of DNA, RNA, cytomorphology, and immunoantigenicity in Residual ThinPrep® Specimens
Younghye Kim, Kap Ro Choi, Moon Jung Chae, Bong Kyung Shin, Han Kyeom Kim, Aeree Kim, Baek‐hui Kim
APMIS.2013; 121(11): 1064. CrossRef
The Development of the Liquid Cell Smear Device for Liquid-Based Cytology Test
Han Yeong Oh, Ha Ju So, Seong Hyun Kim, Dong Wook Kim, Hyun Chang Kim
Applied Mechanics and Materials.2013; 284-287: 1564. CrossRef

A Consideration of MGMT Gene Promotor Methylation Analysis for Glioblastoma Using Methylation-Specific Polymerase Chain Reaction and Pyrosequencing.: Sang Hwa Lee, Tae Sook Hwang, Young Cho Koh, Wook Youn Kim, Hye Seung Han, Wan Seop Kim, Young Sin Ko, So Dug Lim; Korean J Pathol. 2011;45(1):21-29.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.1.21

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Abstract PDF

BACKGROUND
O6-methylguanine-DNA methyltransferase (MGMT) gene promoter methylation is currently the most promising predictive marker for the outcome and benefit from temozolomide treatment in patients with glioblastoma, but there is no consensus on the analysis method for assessing the methylation status in the molecular diagnostic field. The objective of this study was to evaluate methylation-specific polymerase chain reaction (MSP) and pyrosequencing methods for assessing MGMT gene promotor methylation of glioblastoma as well as assessing the MGMT protein expression by immunohistochemistry.
METHODS
Twenty-seven cases of glioblastoma from the archives at the Department of Pathology Konkuk University Hospital were selected. MGMT promoter methylation was evaluated by MSP and the pyrosequencing methods. The MGMT expression was also measured at the protein level by immunohistochemistry.
RESULTS
Overall, MGMT hypermethylation was observed in 44.4% (12/27 cases) of the case of glioblastoma using either MSP or pyrosequencing. The concordant rate was 70.3% (19/27 cases) between MSP and pyrosequencing for MGMT methylation. There was no correlation between MGMT methylation and the protein expression. No significant differences in progression free survival and overall survival were seen between the methylated group and the unmethylated group by using either MSP or pyrosequencing. The status of the MGMT protein expression was correlated with progression free survival (p=0.026).
CONCLUSIONS
In this study the concordance rate between MSP and the pyrosequencing methods for assessing MGMT gene promotor methylation was relatively low for the cases of glioblastoma. This suggests that more reliable techniques for routine MGMT methylation study of glioblastoma remain to be developed because of quality control and assurance issues.

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Prognostic Role of Methylation Status of theMGMTPromoter Determined Quantitatively by Pyrosequencing in Glioblastoma Patients
Dae Cheol Kim, Ki Uk Kim, Young Zoon Kim
Journal of Korean Neurosurgical Society.2016; 59(1): 26. CrossRef
Distinct genetic alterations in pediatric glioblastomas
Sun-ju Byeon, Jae Kyung Myung, Se Hoon Kim, Seung-Ki Kim, Ji Hoon Phi, Sung-Hye Park
Child's Nervous System.2012; 28(7): 1025. CrossRef
MGMTGene Promoter Methylation Analysis by Pyrosequencing of Brain Tumour
Young Zoon Kim, Young Jin Song, Ki Uk Kim, Dae Cheol Kim
The Korean Journal of Pathology.2011; 45(5): 455. CrossRef

Desmoplastic Small Round Cell Tumor with Ovarian Involvement: A Case Report.: Sang Hwa Lee, Wan Seop Kim, Ji Hoon Kim, Hye Seung Han, So Dug Lim, Sang Yoon Kim, Tae Sook Hwang; Korean J Pathol. 2009;43(2):185-188.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.2.185

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Abstract PDF: Desmoplastic small round cell tumor (DSRCT) is a rare, aggressive neoplasm that preferentially involves the abdominal and pelvic cavities in relatively young males. We present a rare case of DSRCT arising in the ovary of a 16-year-old girl. During surgery, a 15 cm-sized huge mass was noted in the right ovary and wide spreading of the tumor was identified in the left ovary, uterine wall, and omentum and bowel wall. Histological investigation showed nests of small round cells with round nuclei and scanty eosinophilic cytoplasm accompanied with dense desmoplastic stroma. The immunohistochemistry showed that the tumor coexpressed epithelial, mesenchymal, and neuronal markers. The tumor cells ultrastructurally showed poorly developed cell junctions and occasionally showed intracytoplasmic aggregates of intermediate filaments. Molecular analysis of the tumor revealed chromosomal translocation t(11:22)(p13;q12) associated with the EWS-WT1 fusion protein. DSRCT should be included in the differential diagnosis of ovarian neoplasms in young patients.

Pleomorphic Hyalinizing Angiectatic Tumor of Soft Parts: A Case Report.: Young Chae Chu, Sun Keun Choi, In Suh Park, Hye Seung Han, Jee Young Han, Joon Mee Kim; Korean J Pathol. 2002;36(3):195-198.

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Abstract PDF: A case of rare pleomorphic hyalinizing angiectatic tumor (PHAT) of soft parts is reported. A 35-year-old woman presented with a subcutaneous solid mass in the left inguinal area, which had been present for 3 months, was presented to us. The tumor was histologically characterized by sheets of mitotically inactive oval and pleomorphic cells, mono-and multinucleated giant cells, intranuclear cytoplasmic inclusions, and prominent clusters of thinwalled ectatic vessels with perivascular hyalinization. A focal hemangiopericytoma-like vascular pattern, pseudovascular spaces, stromal collagen with degenerative change and abundant mast cells were observed. The tumor cells were reactive for vimentin and CD34. This tumor shared several features with malignant fibrous histiocytoma, ancient schwannoma, giant cell angiofibroma, giant cell fibroblastoma and solitary fibrous tumor. The patient was well with no evidence of disease for 10 months.

Immunohistochemical Expression of p53, p21, and mdm2 Proteins in Human Papillomavirus Positive and Negative Invasive Uterine Cervical Carcinomas.: In Seo Park, Hye Seung Han, Tae Sook Kim, Jee Young Han, Joon Mee Kim, Young Chae Chu, Tae Sook Hwang; Korean J Pathol. 2001;35(3):212-219.

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Abstract PDF: BACKGROUND
In the uterine cervical carcinoma, the inactivation of p53 protein by human papillomavirus(HPV) E6 protein has been reported to play a greater role in carcinogenesis than the mutation of the p53 gene. Therefore, the mutation of the p53 gene is rare. p21 and mdm2 proteins are induced by wild-type p53 protein and are involved in the cell cycle regulatory mechanism.
METHODS
Immunohistochemical staining for p53, p21 and mdm2 proteins was performed in 26 HPV-positive and 13 HPV-negative invasive cervical carcinomas together with 5 non-neoplastic cervical tissues.
RESULTS
The frequencies of the expression of p53, p21 and mdm2 proteins were 82.1%, 84.6% and 66.7%, respectively. The expression of p53 protein was less frequently demonstrated in HPV-positive cases than HPV-negative cases, which was statistically a negative correlation(p=0.018). The expression of p53 and p21 proteins was statistically significant(p=0.000).
CONCLUSIONS
p53, p21 and mdm2 proteins were highly expressed in both HPV-positive and HPV-negative cervical carcinomas. Significantly higher expression of p53 protain in HPV-negative cases necessitate a further study for investigating the role of p53 protein accumulation in carcinogenesis of HPV-negative cervical carcinomas. The relationship between the expression of p53 protein and p21/mdm2 proteins may indicate that p21 and mdm2 proteins also have a role in carcinogenesis, where p53 protein plays a fundamental role.

Endobronchial Actinomycosis: A report of two cases.: Hye Seung Han, Kwang Ho Kim, In Seo Park, Jee Young Han, Young Bae Kim, Tae Sook Hwang, Young Chae Chu; Korean J Pathol. 2000;34(6):465-470.

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Abstract PDF: Actinomycosis causes a chronic suppurative infection most commonly involving the cervico-facial region, thorax, and the abdomen. Thoracic infection results from an aspiration of contaminated material from mouth or oropharynx. Actinomyces was known to have a predilection for the periphery of the lung and the endobronchial lesion is extremely rare. We report two cases of actinomycosis presenting as an endobronchial mass which arose in 53-year-old and 44-year-old women. The first case presented with cough, sputum, weight loss and had a history of pulmonary tuberculosis 24 years ago. Chest CT revealed a right lobe collapse simulating mass and suggested carcinoma. The second case presented with hemoptysis for 2 years. Chest CT revealed cystic bronchiectasis of both lungs and intracystic soft tissue mass in the anterior segment of the right upper lobe which suggested aspergilloma. The gross features of them were similar to those of aspergilloma. Characteristic sulphur granules consisting of a granular basophilic center surrounded by a radiating zone of eosinophilic, hyaline, club-shaped projection were histologically confirmed in both cases. Granulomas containing P. westermani eggs were present in the second case. Staphylococcus, true fungal organism, nocardia, and streptomyces shoud be distinguished by analysing their morphologic characteristics in the appropriate stains. Actinomycosis should be included in the differential diagnoses of an endobronchial mass.

Prostatic Intraepithelial Neoplasia in Transurethral Resection Specimens On serum PSA and histologic findings.: Joon Mee Kim, Soo Kee Min, Young Chae Chu, Tae Sook Hwang, Young Bae Kim, Jee Young Han, Tae Sook Kim, Hye Seung Han; Korean J Pathol. 2000;34(5):349-357.

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Abstract PDF: Prostatic intraepithelial neoplasia (PIN), which is divided into low and high grade, has different clinicopathologic significance. We reviewed 158 prostatic tissues, which consisted of 144 cases of nodular hyperplasias and 14 cases of adenocarcinomas, to evaluate incidence of PIN, its histologic finding, and its clinical significance. Ten cases of PIN, 4 low grade and 6 high grade, were found. Four cases of low grade PIN (LPIN) and five cases of high grade PIN (HPIN) were associated with nodular hyperplasia. Only one case of HPIN occurred in carcinoma. The constant histologic findings of LPIN were nuclear stratification and nucleomegaly. The most prominent characteristics of HPIN were hyperchromasia and prominent nucleoli. Anisonucleosis was not so helpful for differential diagnosis between LPIN and HPIN. Basal layer disruption was present in one case of high grade PIN associated with adenocarcinoma, and important for the differentiatial diagnosis of cribriform HPIN from the cribriform adenocarcinoma. There was no significant difference in age incidence between the two groups with the mean age of 70.9 years in nodular hyperplasia and 69.4 years in adenocarcinoma. Serum PSA level was significantly different between the two group with the mean PSA value of 11.03 ng/ml in nodular hyperplasia and that of 73.76 ng/ml in carcinoma (p=0.000). However, PSA values between "nodular hyperplasia only" group and "PIN associated nodular hyperplasia" group were not significantly different. PIN association changed neither age distribution nor serum PSA level. During the follow up period, no adenocacinoma has occurred in the cases having PIN although serum PSA level has elevated in some cases. One case of adenocarcinoma associated with HPIN developed in the nodular hyperplasia patient. Although PIN did not increase the possibility of subsequent prostatic adenocarcinoma in transurethral resection specimens, it could not be excluded that PIN was a precursor of prostatic adenocarcinoma.

Expression of Insulin-like Growth Factor-I-Receptor in Colorectal Adenomas and Carcinomas.: Young Chae Chu, Hye Seung Han, Jee Young Han, Joon Mee Kim, Young Bae Kim, Tae Sook Hwang; Korean J Pathol. 2000;34(3):199-207.

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Abstract PDF: The activation of the insulin-like growth factor-I-receptor system (IGF-IR) has recently emerged as critical events in transformation and tumorigenicity of several human tumors. In this study we investigated the expression of IGF-IR in 33 colorectal adenomas, 88 primary colorectal carcinomas, and 30 normal colonic mucosa adjacent to the carcinoma. Immunohistochemical staining (IHC) for IGF-IR was performed on paraffin embedded sections using an anti-IGF-IR rabbit polyclonal antibody. IHC stains for IGF-IR were scored using a semiquantitative scoring system. The relationship of IGF-IR staining to clinicopathologic variables and proliferating cell nuclear antigen (PCNA) staining was also analysed. The mean IHC scores for IGF-IR of normal glands, adenoma, intramucosal carcinoma, node-negative carcinoma, and node-positive carcinoma were 0.41 0.96, 0.76 1.23, 2.0 1.48, 2.83 2.0 and 5.93 1.58, respectively. These scores for each category were statistically significant except between normal glands and adenoma and between intramucosal carcinoma and node-negative carcinomas. The mean PCNA indexes of normal glands, adenoma, intramucosal carcinoma, node-negative carcinoma, and node-positive carcinoma were 2.48 2.60, 6.94 11.03, 27.21 11.42, 43.36 9.9 and 57.60 10.01, respectively. The PCNA index for each category was statistically significant except between normal and adenoma. IGF-IR scores and PCNA indexes were higher with tumor progression and also correlated each other (sr=0.65, p=0.0001). Higher IGF-IR scores and PCNA indexes were seen in tumors with advanced stage, infiltrative growth pattern, poor differentiation, nerve invasion, lymphovascular invasion, and moderate fibrosis. Our results suggest that IGF-IR plays an important role in tumorigenicity and tumor progression.

Fine Needle Aspiration Cytology of Alveolar Soft Part Sarcoma: A Case Report .: Hye Seung Han, In Seo Park, Jee Young Han, Joon Mee Kim, Young Bae Kim, Tae Sook Hwang, Young Chae Chu; Korean J Cytopathol. 2000;11(2):115-119.

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Abstract PDF: Alveolar soft part sarcoma is a rare soft tissue tumor. Few cases of fine needle aspiration cytology have been reported in the literature. We experienced a case of recurrent alveolar soft part sarcoma of the right thigh diagnosed by fine needle aspiration cytology in a 47-year-old man. Cytologic findings showed single cells and clusters associated with thin walled vasculature in a distinct pseudo-alveolar pattern. The tumor cells exhibited round or ovoid abundant granular cytoplasm and large pleomorphic nuclei with prominent central nucleoli.

Expression of Maspin Protein in Ductal Hyperplasia, Intraductal Carcinoma and Invasive Ductal Carcinoma of the Breast.: Young Chae Chu, In Seo Park, Yoon Ju Kim, Joon Mee Kim, Hye Seung Han, Jee Young Han, Young Bae Kim; Korean J Pathol. 1999;33(8):614-619.

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Abstract PDF: Maspin is a recently described gene with tumor suppressor activity. The gene product is a 42 kD protein with homology to the serpin family of protease inhibitors and may play a role as an inhibitor of tumor cell invasion. The prior observation that invasive breast cancers and their metastases showed decreased maspin protein expression by immunostaining supports this speculation. However, the role of maspin in breast cancer progression has not been studied in detail. We, therefore, studied maspin protein expression in a series of hyperplasia, atypical ductal hyperplasia, intraductal carcinoma and invasive carcinomas. Immunohistochemical staining (IHC) for maspin was performed on paraffin sections of 136 breast specimens using a commercially available monoclonal antibody. Among the 106 cases studied were 36 moderate/florid ductal hyperplasia, 11 atypical ductal hyperplasia (ADH), 29 intraductal carcinoma (IDC) (4 low grade, 13 intermediate grade, 12 high grade) and 30 invasive ductal carcinomas. Thirty cases of normal breast were also studied as control group. IHC stains were scored using a semiquantitative scoring system. The mean IHC scores for maspin for normal, moderate/florid hyperplasia, atypical ductal hyperplasia, intraductal carcinoma, and invasive carcinoma were 5.51 1.30, 7.36 0.72, 3.82 1.60, 4.48 2.69, 3.97 3.30, respectively. These scores for each category were statistically significant (p<0.05), except between ADH and IDC. Maspin protein expression was increased in most cases of moderate/florid hyperplasia, while maspin expression was more heterogeneous in ADH and IDC. In high grade IDC, maspin protein expression was stronger than low and intermediate grade IDC, and this suggests the possibility of a compensatory cellular response against the forces driving further tumor progression. Two thirds of invasive ductal carcinomas expressed maspin protein weakly and focally. All metastatic carcinomas of lymph nodes were negative for maspin. It is possible that high grade IDC with strong maspin expression may represent a subset less likely to progress to invasive cancer. This speculation merits investigation in clinical outcome studies.

Fibro-osseous Pseudotumor of the Digits: A case report .: In Seo Park, Jee Young Han, Hye Seung Han, Young Bae Kim, Young Chae Chu; Korean J Pathol. 1999;33(7):540-543.

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Abstract PDF: Fibro-osseous pseudotumor of the digits is a heterotopic ossification closely related to myositis ossificans and occurs in the subcutaneous tissue of the digits. This lesion is considered a reactive fibroblastic proliferation with metaplastic bone formation. We report a case of fibro-osseous pseudotumor of left index finger in a 28-year-old woman. She had had an ovoid smooth subcutaneous mass with tenderness on the left index finger for one month. In gross, the specimen consisted of a relatively circumscribed, rubbery soft mass with grayish white cut surface measuring 2.0 1.7 1.5 cm. Upon microscopic examination the lesion showed irregular multinodular growth with considerably variable cellularity. Because of the focal hypercellularity, cellular atypia, and increased mitotic activity this lesion may be confused with extraskeletal osteosarcoma or parosteal osteosarcoma. This rare lesion is curable by complete local excision.

Cytologic Features of an Angiosarcoma in Pleural Fluid: A Case Report .: Young Chae Chu, In Seo Park, Yoon Ju Kim, Hye Seung Han, Jee Young Han; Korean J Cytopathol. 1999;10(1):61-66.

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Abstract PDF: Angiosarcomas are rare tumors, seen most commonly in the skin and soft tissue of head and neck region. But it has been described in numerous body sites including thyroid, breast, liver, spleen, bone, etc.. Their biological behaviors depend on the microscopic grade, site of origin, and multifocality. We report the unique cytological features of an angiosarcoma in pleural fluid. A 61-year-old woman presented with a 6 month history of dyspnea on exertion and chest pain. Chest computerized tomography(CT) revealed multiple subpleural small nodules in the right lung and widespread air space consolidation and pleural effusion in the left lung. CT of liver revealed multiple small low attenuated lesion. The smears obtained from pleural fluid showed hypocellularity with a hemorrhagic background. The tumor cells were highly pleomorphic oval or spindle in shape and presented singly, in loose groups, in knitted syncytial aggregates, and in acinar pattern. Their nuclei had vesicular chromatin with delineated, thick nuclear membranes and occasionally a large eosinophilic, prominent nucleolus. The cytoplasm was plump, thin or projected in spindly fashion. Almost all tumor cells showed variable sized intracytoplasmic vacuoles and their nuclei were sometimes crescentic by a huge vacuole. Occasional binucleated tumor cells and mitotic figures were present. Cellular debris and streaky materials were identified. Needle biopsy specimen from the pleura revealed anastomosing slit-like spaces lined by pleomorphic tumor cells. The tumor cells showed a strong reactivity for CD31 and vimentin and focal weak reactivity for factor VIII-related antigen.

The Value of Immunohistochemistry on Paraffin Embedded Tissue Sections in the Differentiation of Subgroups of Low Grade B-Cell Lymphomas.: Tae Sook Hwang, Seung Sook Lee, Ji Eun Kim, Hye Seung Han, Chul Woo Kim; Korean J Pathol. 1998;32(12):1066-1073.

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Abstract: There had been a continuous evolution of lymphoma classification and recently a Revised European-American Lymphoma Classification was proposed by the International Lymphoma Study Group. This new classification often requires information on immunophenotypic and molecular biologic markers in addition to the usual histologic findings. Recent advances in the production of commercially available monoclonal antibodies reactive on formalin-fixed paraffin-embedded tissues provide us a great help to classify the non-Hodgkin's lymphoma. We have analyzed 31 low grade B-cell lymphomas by the schemes proposed by the International Lymphoma Study Group using antibodies to CD3, CD5, CD20, CD23, CD43, cyclin D1, and bcl-2 protein, and have analyzed the immunophenotypic features. Among 31 low grade B-cell lymphomas, 8 small lymphocytic lymphomas, 5 mantle cell lymphomas, 7 follicle center lymphomas (2 grade I, 3 grade II, and 2 grade III), and 11 marginal zone B-cell lymphomas (all of which were extranodal) were identified. Among 8 small lymphocytic lymphomas, 5 cases were positive for CD5; 6 cases were positive for CD23; 7 cases were positive for CD43; all 8 cases were negative for cyclin D1; and 7 cases were positive for bcl-2. Among 5 mantle cell lymphomas, 4 cases were positive for CD5 and CD43; all five cases were negative for CD23; 4 cases were positive for cyclin D1 and bcl-2. All 7 follicle center lymphomas were negative for CD5, CD43 and cyclin D1 and 2 cases were positive for CD23; and 6 cases were positive for bcl-2. All marginal zone B-cell lymphomas were negative for CD5, CD23 and cyclin D1; 3 cases were positive for CD43 and 9 cases were positive for bcl-2. Diagnostic utility for CD5 antigen detection on paraffin embedded tissue has a limitation due to weak antigen expression in tumor cells of B-cell lymphomas; however, still be useful in differentiating small lymphocytic lymphoma and mantle cell lymphoma from other B-cell lymphomas when applied in conjunction with CD43. CD23, CD43, and cyclin D1 appear to be of great help in differentiating subgroups of low grade B-cell lymphomas. Bcl-2, as known, is found to be useful to rule out reactive follicular hyperplasia.

Detection of Mycobacterium tuberculosis DNA in Ethanol-Fixed and Papanicolaou Stained Archival Materials.: Tae Sook Hwang, In Seo Park, Hye Seung Han, Jee Young Han, Young Bae Kim; Korean J Pathol. 1998;32(8):603-607.

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Abstract: Granuloma is a chronic inflammatory process associated with non-infectious agents or infectious diseases such as tuberculosis. It is well known that AFB staining, which has been used to determine the etiology of the granulomatous inflammation, lacks both sensitivity and specificity. Due to the slow growth rate of most pathogenic mycobacteria, culturing of organisms can take up to eight weeks. It is not uncommon for specific therapy to be delayed, or for an inappropriate treatment be given to patients without mycobacterial infections or with infections caused by atypical mycobacteria. Determination of the causative agent in Papanicolaou stained cytology specimens gives pathologists even more difficulties when only necrotic material has been aspirated from the center of the granuloma. In recent years, the use of a polymerase chain reaction for the amplification of DNA has appeared promising in terms of speed, efficiency, sensitivity, and specificity. Since a polymerase chain reaction permits the sensitive genetic analysis of small amounts of tissue, it is ideally suited to the genetic analysis of cytologic specimens. A polymerase chain reaction is easily performed on unfixed and unstained cells, however, an analysis of ethanol fixed and Papanicolaou-stained archival smears has also been described. We have recently established a method to detect Mycobacterium tuberculosis organism by a nested polymerase chain reaction with primers in the insertion sequence IS 6110, using cellular digests of ethanol-fixed and Papanicolaou-stained archival specimens aspirated from the lymph nodes, lungs, thyroid, etc. Inhibitors present in Papanicolaou stained material was removed by destaining the slides with 0.5% HCl solution for 10-30 minutes. Eight out of ten cases which have shown the epithelioid granulomas revealed a positive reaction and four out of ten cases which have shown lymphohistiocytic cells in a necrotic background without any evidence of granuloma revealed a positive reaction. This study showed that it was possible to employ a polymerase chain reaction to detect Mycobacterium tuberculosis in Papanicolaou stained archival cytology specimens.

Comparison between Immunohistochemical Stains and Serum Hormone Level on Pituitary Adenomas.: Hye Seung Han, Yeon Lim Suh; Korean J Pathol. 1998;32(2):88-93.

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Abstract PDF: The current classification of pituitary adenomas is based on cell type, largely ascertained by immunohistochemistry and electron microscopy. In an application of immunohistochemistry, pathologists have some problems in judging the results. An immunostaining result does not always correspond with a serum hormone level. It is also difficult to determine the nature of a tumor when a few cells are positive. We performed the immunohistochemical stains on 34 pituitary adenomas using polyclonal antibodies to six pituitary hormones [PRL (prolactin), GH (growth hormone), ACTH (adrenocorticotropic hormone), FSH (follicle-stimulating hormone), LH (luteinizing hormone), TSH (thyroid-stimulating hormone)] and compared with serum hormone level. The serum hormone level was increased in 14 cases (41.2%) of PRL, 7 cases (20.6%) of PRL & GH, 6 pleurihormonal cases (17.6%), 4 nonfunctioning cases (11.8%), 2 cases (5.9%) of FSH, and 1 case (2.9%) of GH. The most common immunohistochemical type of pituitary adenoma was 10 prolactinoma cases (38.5%), followed by 7 pleurihormonal cases (26.9%), 4 null cell cases (15.4%), 3 cases of mixed PRL & GH (11.5%), 1 case of ACTH (3.8%) and 1 FSH & LH case (3.8%). The corresponding rates of the serum hormone level and immunostaining results were 94.1% in GH, 88.9% in TSH, 85.7% in LH, 82.4% in ACTH, 66.7% FSH, and 61.8% in PRL. In the immunostaining for FSH, 12 cases showed less than 5% positivity and most of them exhibited the normal serum hormone level. In conclusion, the most common elevated serum hormone and immunohistochemical type of pituitary adenoma was prolactinoma. The corresponding rate of the serum hormone level and immunostaining result was the highest in GH cell adenoma and was the lowest in prolactinoma. The cells showing less than 5% positivity seem to be entrapped normal cells.

Decubitoma: A Pseudosarcoma in Decubitus: Report of a case.: Hye Seung Han, Yong Il Kim, Jeong Wook Seo; Korean J Pathol. 1996;30(11):1060-1064.

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Abstract PDF: Decubitus ulcer is often seen in the skin and underlying tissue of debilitated or immobilized patients as the result of prolonged pressure and impaired circulation. It manifests chiefly as an ulcer over bony prominences, but tumefaction is an extremely unusual presentation. A 53-year old male, a paralytic of the lower extremity for 18 years, developed a recurrent decubital ulcer despite repeated surgical repair, from which a rapidly growing, large fungating mass grew within a month. The last resected mass was bosselated and measured 15x9x3 cm with a major area of cicatrix-like induration, interdigitated with skeletal muscle bundles at the central area. Microscopically, the mass was composed of an upper half of active granulation tissue layer and a deeper half of dense, poorly cellular, fibrocollagenous bundles admixed with florid proliferation of atypical fibroblasts, but the absence of mitosis and the multifocal admixture of active inflammatory process-granulation tissue formation seemed to help exclude genuine fibromatosis, nodular fasciitis or proliferative myositis. We assume that this rapidly growing pseudofibromatosis is an additional manifestation of a prolonged decubitus ulcer, possibly related to the modified reparative process of decubitus ulcer following repeated excisions, for which we propose a term of decubitoma.

Intraabdominal Heterotopic Thymus: Report of an autopsy case.: Hye Seung Han, Je Geun Chi; Korean J Pathol. 1996;30(11):1057-1059.

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Abstract PDF: Ectopic thymus results from the aberrant migration of thymic tissue and is mostly present in the mediastinum, the base of the skull, the tracheal bifurcation and the cervical region. We report the first case of intraabdominal heterotopic thymus incidentally detected and attached to the liver without associated anomalies. This fetus was sent to the Department without any clinical information. The fetus was small for gestational age, but had no external abnormalities. Each organ showed normal development except for the liver. The liver weighed 6 gm(normal 17.064+/-4.143 gm). Gray white heterotopic thymus was attached to the superior surface of the liver in the subdiaphragmatic area. It measured 1.1x0.6x0.5 cm. There was no diaphragmatic defect. The cervical thymic tissue near the thyroid was small and measured 0.2 gm(normal 0.927+/-0.485 gm). There was no thymic tissue in the anterior superior mediastinum. The histologic features of the heterotopic thymus were identical to the orthotopic thymus showing features appropriate for the gestational age. The origin of this subdiaphragmatic heterotopic thymus is speculated.

Beckwith-Wiedemann Syndrome with Unusual Sialoadenomegaly.: Hye Seung Han, Seung Sook Lee, Suk Keun Lee, Je G Chi; Korean J Pathol. 1996;30(10):939-942.

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Abstract PDF: Beckwith-Wiedemann syndrome is a rare clinical entity characterized by exomphalos, macroglossia, macrosomia, and renal hyperplasia/dysplasia. Although its entity is established, its etiology and obligatory features have not been settled. We report an autopsy case with the unusual involvement of the salivary gland. This infant was born to a 37-year-old mother as a normal full-term spontaneous delivery. At 11 days of age she developed with purulent eye discharge and weak sucking, and died suddenly. At autopsy the baby weighed 2,630 gm and the head circumference was 35 cm. She showed thick and prominent skin folds, bilateral aural fissures, macroglossia, hepatomegaly, cardiomegaly, dysmorphic kidneys, and nesidioblastosis. Both kidneys showed dysplastic tubules and hyperplastic cortical tissue enclosing the medulla. In this case there were characteristic findings in major and minor salivary glands with both acinar and ductal hyperplasia, and hypertrophy of mammary glands. Besides, she had generalized depletion of subcutaneous fat, immature buccal fat, patent ductus arteriosus, hyperlobation of the right lung, two accessory spleens, and hyperplasia of basophils and chromophobes in the pituitary gland. The lungs showed diffuse interstitial pneumonia and multiple fibrin thrombi. There were no adrenal cytomegaly, umbilical hernia and exophthalmos.

Immunohistochemical Study of Primary Large Cell Undifferentiated Carcinoma of the Lung.: Hye Seung Han, Jeong Wook Seo, Eui Keun Ham; Korean J Pathol. 1996;30(5):417-426.

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Abstract PDF: We performed a histopathologic and immunohistochemical study of 23 cases of surgically resected large cell undifferentiated carcinoma(LCUC) of the lung. The relative incidence of LCUC was 7.6% among the total resected cases of primary lung cancer over 7 years(1987-1993). The mean age of the patients was 56 years and 21 cases were male. The mean size of the mass was 5 cm and 11 cases were located peripherally. According to the histologic features, LCUC could be divided into three groups: squamous cell carcinoma-like(6 cases), adenocarcinoma-like(13 cases), and small cell carcinoma-like(4 cases) groups. The histologic differences were related to the variations of the immunohistochemical properties, but there were no differences in prognosis among these groups. Immunoreactivity to cytokeratin(CAM 5.2) was demonstrated in 22/23(96%). Carcinoembryonic antigen was positive in 13/23(57%). Neuron specific enolase and chromogranin were positive in 11/23(48%) and 5/23(22%), respectively. Vimentin was seen in 11/23(48%). From these observations, we could subclassify them by their immunologic phenotypes; exocrine features in 6/23(26%), neuroendocrine(NE) features in 4/23(17%), both exocrine and NE phenotypes in 7/23(30%), and 6 cases(26%) showed neither phenotype. The group with NE features showed a worse prognosis(P<0.05) and immunoreactivity for vimentin was also related to a worse prognosis(P<0.05). These findings imply that the immunohistochemical properties of LCUC are closely related to the histopathologic features. The groups, subdivided by histology and immunoreactivity, showed no prognostic difference except for the NE differentiation and reaction for vimentin.

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