Journal of Pathology and Translational Medicine

Joungho Han

19 Articles

Pulmonary Vascular Sarcomas: Clinicopathologic Analysis of 14 Cases.: Na Rae Kim, Jhingook Kim, Seung Yeon Ha, Joungho Han; Korean J Pathol. 2011;45(2):132-138.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.2.132

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BACKGROUND
Pulmonary vessel sarcomas are rare, and their pathogenesis is still unclear.
METHODS
We focus on the pathologic findings of fourteen pulmonary artery and/or vein sarcomas along with clinical prognosis.
RESULTS
Nine patients were male and five were female, and they ranged in age from 26 to 72 years (mean, 47 years). There were ten cases of pulmonary artery sarcoma, three cases of pulmonary artery and vein sarcoma, and one case of pure pulmonary vein sarcoma. Ten out of the fourteen cases were associated with pulmonary thromboembolism. Microscopically, all the tumors showed an undifferentiated sarcomatous portion. There were leiomyosarcoma portions in 8 cases, malignant fibrous histiocytomatous portions in 7 cases, angiosarcomatous differentiation in 3 cases, and osteosarcomatous portion in 1 case. All but two patients died during the follow up period (range, 1 to 78 months). The mean survival time of the patients who died was 14 months and the longest survival time was 78 months after surgical resection.
CONCLUSIONS
The current study is one of the largest single institutional reviews of pulmonary artery and/or vein sarcoma. Regardless of the histological components and macroscopic growth patterns, these rare tumors have a grave prognosis.

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Therapeutic Use of Bee Venom and Potential Applications in Veterinary Medicine
Roberto Bava, Fabio Castagna, Vincenzo Musella, Carmine Lupia, Ernesto Palma, Domenico Britti
Veterinary Sciences.2023; 10(2): 119. CrossRef
Intimal Sarcoma of the Great Vessels
Alan M. Ropp, Allen P. Burke, Seth J. Kligerman, Jay S. Leb, Aletta A. Frazier
RadioGraphics.2021; 41(2): 361. CrossRef
Incidence of pulmonary non-epithelial tumors: 18 years’ experience at a single institute
In Ho Choi, Dae Hyun Song, Kang Min Han, Yong Soo Choi, Joungho Han
Pathology - Research and Practice.2014; 210(4): 210. CrossRef
Pleomorphic Malignant Histiocytoma of Pulmonary Arteries Presenting as Pulmonary Aneurysms
Gustavo Armando De La Cerda Belmont, Carlos Alberto Lezama Urtecho
The Annals of Thoracic Surgery.2013; 95(3): 1091. CrossRef

Mucoepidermoid Carcinoma of Tracheobronchial Tree: Clinicopathological Study of 31 Cases.: Sang Yun Ha, Joungho Han, Jae Jun Lee, Young Eun Kim, Yoon La Choi, Hong Kwan Kim; Korean J Pathol. 2011;45(2):175-181.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.2.175

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Abstract PDF

BACKGROUND
All aspects of mucoepidermoid carcinoma (MEC) of the lung including histologic grading, clinical behavior and its differentiation from adenosquamous cell carcinoma are still not fully understood.
METHODS
We reviewed the hematoxylin-eosin stained slides and medical records of 31 cases of MEC of the lungs. The cases were classified as low and high grade according to the quantitative grading system formulated for MEC. High grade tumors were tested for an epidermal growth factor receptor (EGFR) mutation.
RESULTS
Twenty eight cases were classified as low grade and 3 cases as high grade. Histologically, lower glandular component, cellular atypia, necrosis, mitoses >4/10 high power fields, and endolymphatic tumor emboli were typical characteristics of a high grade tumor. Although some tumors showed histologic features mimicking high grade tumors, they were classified as low grade tumors according to this quantitative grading system. Low grade tumors showed no recurrence or metastasis. However, among three patients with a high grade tumor, two had distant metastases and one died of disease. Additionally, an EGFR mutation was not detected.
CONCLUSIONS
A high grade MEC was consistently different from a low grade tumor with regard to malignant histologic features and poor prognosis. Therefore, correct histologic grading is important in predicting the prognosis to avoid unnecessary treatment.

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A rare case of endobronchial mucoepidermoid carcinoma of the lung presenting as non-resolving pneumonia
Toolsie Omesh, Ranjan Gupta, Anjali Saqi, Joshua Burack, Misbahuddin Khaja
Respiratory Medicine Case Reports.2018; 25: 154. CrossRef
Cutaneous Involvement by Nasal Mucoepidermoid Carcinoma: The Tip of the Iceberg Phenomenon
Ge Zhao, Oliver Chang, John Streidl, Amit Bhrany, Kyle Garton, Timothy H. McCalmont, Paul E. Swanson, Zsolt Argenyi, Michi M. Shinohara
Journal of Cutaneous Pathology.2017; 44(2): 113. CrossRef
Surgical outcomes of pulmonary mucoepidermoid carcinoma: A review of 41 cases
Chih-Cheng Hsieh, Yung-Han Sun, Shih-Wei Lin, Yi-Chen Yeh, Mei-Lin Chan, Pei-Yi Chu
PLOS ONE.2017; 12(5): e0176918. CrossRef
Clinicopathologic characteristics of EGFR, KRAS, and ALK alterations in 6,595 lung cancers
Boram Lee, Taebum Lee, Se-Hoon Lee, Yoon-La Choi, Joungho Han
Oncotarget.2016; 7(17): 23874. CrossRef
Metastatic Pulmonary Mucoepidermoid Carcinoma with Fulminant Clinical Course
Yong Won Park, Seon Bin Yoon, Mi Ju Cheon, Young Min Koh, Hyeon Sik Oh, Se Joong Kim, Seung Hyeun Lee
The Ewha Medical Journal.2015; 38(2): 85. CrossRef
Lung cancer in never-smoker Asian females is driven by oncogenic mutations, most often involving EGFR
Sang Yun Ha, So-Jung Choi, Jong Ho Cho, Hye Joo Choi, Jinseon Lee, Kyungsoo Jung, Darry Irwin, Xiao Liu, Maruja E. Lira, Mao Mao, Hong Kwan Kim, Yong Soo Choi, Young Mog Shim, Woong Yang Park, Yoon-La Choi, Jhingook Kim
Oncotarget.2015; 6(7): 5465. CrossRef
Bronchoscopic Resection of an Exophytic Endoluminal Tracheal Mass
Russell J. Miller, Septimiu D. Murgu
Annals of the American Thoracic Society.2013; 10(6): 697. CrossRef
EGFR mutations and mucoepidermoid carcinoma: Putative significance in differing populations
Iain D. O’Neill
Lung Cancer.2012; 78(1): 125. CrossRef

Diffuse Pulmonary Meningotheliomatosis: A Case Report.: Jungsuk An, Heejung Park, Joungho Han, Tae Sung Kim, Yong Soo Choi, Moon Seok Choi, Sang Won Um; Korean J Pathol. 2011;45:S32-S35.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.S1.S32

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Abstract PDF

Diffuse pulmonary meningotheliomatosis (DPM) is an extremely rare condition. We herein report a unique case of DPM in a 54-year-old woman with a previous history of hepatocellular carcinoma. A chest computed tomography showed diffuse bilateral nodular infiltration, suggesting miliary spread of metastatic hepatocellular carcinoma. The patient underwent a video-assisted thoracoscopic surgery for diagnostic purposes. The cut surface of the lung specimen showed multiple dispersed small nodules, consisting of variably sized nests or whorls of bland epithelioid cells often along the walls of alveolar septa or in a perivascular network within the alveolar interstitium. The tumor cells showed immunoreactivity for epithelial membrane antigen, vimentin, and progesterone receptor. DPM should be included in the differential diagnosis of diffuse multiple small nodules or a reticular pattern in the radiologic studies.

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Minute Pulmonary Meningothelial-Like Nodules Simulating Hematogenous Lung Metastasis: A Case Report
Sang Kook Lee, Gi Jeong Kim, Young Jae Kim, Ah Young Leem, Eu Dong Hwang, Se Kyu Kim, Joon Chang, Young Ae Kang, Song Yee Kim
Tuberculosis and Respiratory Diseases.2013; 75(2): 67. CrossRef

Localized Primary Thymic Amyloidosis Presenting as a Mediastinal Mass: A Case Report.: Sang Yun Ha, Jae Jun Lee, Heejung Park, Joungho Han, Hong Kwan Kim, Kyung Soo Lee; Korean J Pathol. 2011;45:S41-S44.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.S1.S41

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Abstract PDF

We herein describe a case of a 55-year-old healthy woman with localized primary thymic amyloidosis presented as a mediastinal mass, found incidentally by chest radiography. Computed tomography revealed a 4.1 cm soft tissue lesion with nodular calcification in the left anterior mediastinum. The resected specimen was a well-defined lobulating mass with calcification. Microscopically, the mass was consisted of amorphous eosinophilc hyalinized substances involving the thymus and intrathymic lymph nodes. These eosinophilic substances showed apple-green bi-refringence under polarized light after staining with Congo red. In immunohistochemical study, they were positive for kappa and lambda light chains and negative for amyloid A. There was no evidence of systemic amyloidosis in clinical investigations. A final diagnosis of localized primary thymic amyloidosis was made.

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EBUS-TBNA diagnosis of localised amyloidosis presenting as mediastinal lymphadenopathy
Avnee Kumar, Barathi Sivasailam, Ellen Marciniak, Janaki Deepak
BMJ Case Reports.2018; 11(1): e226619. CrossRef
Ocular Myasthenia Gravis Associated With Thymic Amyloidosis
Kristin O. Chapman, Debra M. Beneck, Marc J. Dinkin
Journal of Neuro-Ophthalmology.2016; 36(1): 50. CrossRef
Localized Thymic Amyloidosis Presenting with Myasthenia Gravis: Case Report
Seung-Myoung Son, Yong-Moon Lee, Si Wook Kim, Ok-Jun Lee
Journal of Korean Medical Science.2014; 29(1): 145. CrossRef

Mucinous Bronchioloalveolar Carcinoma Associated with Bronchiectatic Cyst: A Brief Case Report.: Chang Ohk Sung, Joungho Han, Sang Won Um, Chin A Yi, Young Mog Shim; Korean J Pathol. 2010;44(5):540-542.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.5.540

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Abstract PDF: Herein we report a rare case of mucinous bronchioloalveolar carcinoma (BAC) associated with a solitary bronchiectatic cyst in a 29-year-old man. The patient presented with hemoptysis and had a history of pulmonary tuberculosis. Chest radiographs and computed tomography revealed a well-circumscribed, thin-walled cavitary lesion in the right upper pulmonary lobe. Gross examination of a lobectomy specimen showed a bronchiectatic cavity and a fungus ball within it. There were also several ill-defined small gray-white nodules around the cyst, nodules that were mucinous BAC. On microscopy, they were composed of columnar tumor cells along the intact alveolar walls in a single layer.

Thymofibrolipoma: A Brief Case Report.: Gu Hyun Kang, Joungho Han, Tae Sung Kim, Yong Soo Choi, Sang Won Um; Korean J Pathol. 2010;44(3):338-340.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.3.338

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Abstract PDF

Thymofibrolipoma is an extremely rare tumor in the anterior mediastinum, and represents a histologic variant of the usual thymolipoma. Herein, we report a case of thymofibrolipoma in a 9-year-old girl who had a huge mass with fatty attenuation in the right hemithorax on chest computed tomography. She denied any subjective symptoms except mild fever. The surgically resected tumor was ovoid, soft and well-encapsulated, measuring 9.0 x 7.5 x 7.0 cm. The cut surface was light tan in color with yellowish streaks. Microscopically, two distinct areas were admixed in different proportions. One consisted of normal thymic tissue with subinvoluted features and the other was composed of extensive areas of collagenous tissue interspersed in mature adipose tissue. In a high power view, there were thin strands of remnant thymic epithelial cells, separating the pseudolobules. Thymofibrolipoma should be distinguished from other benign or malignant conditions, occurring in the anterior mediastinum, so that unnecessary treatment can be avoided.

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Unusual thymoma subtypes
Michael A. den Bakker
Diagnostic Histopathology.2023; 29(2): 105. CrossRef
Thymofibrolipoma: a case report and review of the literature
Ryu Jokoji, Emiko Tomita
Diagnostic Pathology.2022;[Epub] CrossRef
Thymoangiolipoma: A rare histologic variant of thymolipoma in a patient with myasthenia gravis
Mohammad Hossein Anbardar, Fatemeh Amirmoezi, Armin Amirian
Rare Tumors.2020; 12: 203636132097921. CrossRef

Pathologic Findings of Surgically Resected Nontuberculous Mycobacterial Pulmonary Infection.: Hye Jong Song, Jung Suk An, Joungho Han, Won Jung Koh, Hong Kwang Kim, Yong Soo Choi; Korean J Pathol. 2010;44(1):56-62.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.1.56

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Abstract PDF: BACKGROUND
Surgical resection of the involved lung for nontuberculous mycobacteria (NTM) has become an important curative therapy. However, there is limited information on the histopathological features of NTM pulmonary disease in Korean patients with NTM infection.
METHODS
We evaluated 51 specimens from 49 patients who were treated at our referral center from 2002 to 2009.
RESULTS
Almost all the cases showed bronchiectasis with lymphocytic infiltration. Variable features of granulomatous inflammation were found; well-defined granulomas in the parenchyma (68.6%), pneumonia-like granulomatous lesions (49.0%) and granulomatous inflammation in the bronchial wall (41.2%) were identified. The microscopic findings of cavitary lesions (37.3%) showed that these lesions were composed of granulomas and necrosis.
CONCLUSIONS
The differentiation of tuberculosis from NTM could not be accurately made based solely on the histological features. However, the airway centered tendency of NTM reflected an airborn etiology, and this could be correlated with the classification according to the radiological findings. In addition, coexisting constitutional lung diseases, and especially bronchiectasis, were suspected to be predisposing conditions for NTM organisms to colonize and progress to true NTM pulmonary disease.

Graft-Versus-Host Disease of the Lung after Allogeneic Hematopoietic Stem Cell Transplantation: A Report of Two Cases.: Ji Hyeon Roh, Joungho Han, Keon Hee Yoo, Kang Mo Ahn, Jihye Kim; Korean J Pathol. 2009;43(4):378-381.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.4.378

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Abstract PDF: Herein, we describe cases of pulmonary acute graft-versus-host disease (aGVHD) in two patients occurring after allogeneic hematopoietic stem cell transplantation (HSCT) due to precursor B-cell acute lymphoblastic leukemia in a 6-year-old patient and in acute myeloid leukemia in a 14-year-old boy. In both cases, chest CT revealed confluent ground-glass attenuation along the bronchovascular bundles, as well as some bronchial dilatation. Microscopically, in both cases we noted a characteristic bronchiolocentric pattern and bronchiolar epithelial changes, which included denudation of the bronchiolar epithelium, regenerating atypical cells, and wall thickening with subepithelial or transmural fibroblast proliferation, along with some lymphocytic infiltration. One patient died on day 86 after allogeneic HSCT due to sudden acute respiratory distress syndrome, and the other patient currently remains alive without active aGVHD. The authors' experiences in these two cases demonstrate that intense awareness of the pathologic findings of GVHD is mandatory after allogeneic HSCT.

Squamous Cell Carcinoma Arising in a Thymic Cyst : A Brief Case Report.: Chang Ohk Sung, Joungho Han, Ji Yeon Kim, Young Mog Shim, Tae Sung Kim; Korean J Pathol. 2009;43(3):260-262.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.3.260

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Abstract PDF

We present here the case of a 73-year-old man with squamous cell carcinoma that arose in a thymic cyst, and this was incidentally found by chest radiography. Computed tomography revealed a 3.6 cm-sized predominantly cystic lesion with a mural nodule at the antero-superior mediastinum. The resected specimen was a well demarcated cystic mass with a solid mural nodule. Microscopically, the nodule was determined to be invasive squamous cell carcinoma that had originated from the benign squamous epithelium lining the thymic cyst.

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Multilocular Thymic Cyst with Prominent Lymphoid Follicular Hyperplasia: A Case Report
Na-Ra Yoon, Ji Yun Jeong, Joungho Han, Jhingook Kim, Chin A Yi
Journal of Lung Cancer.2012; 11(1): 45. CrossRef

Solitary Pulmonary Mixed Squamous Cell and Glandular Papilloma: A Brief Case Report.: Chan Ohk Sung, Jhingook Kim, In Gu Do, Joungho Han; Korean J Pathol. 2008;42(6):393-395.

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Abstract: Pulmonary mixed squamous cell and glandular papillomas are extremely rare-only a few cases have been reported worldwide. We report a case of mixed squamous cell and glandular papilloma that presented as a solitary pulmonary nodule in a 53-year-old man. The tumor was located in the peripheral small bronchus of the posterobasal segment of the right lower lobe. Microscopically, the tumor was composed of papillary structures lined by squamous and glandular epithelium with mucous material. The fibrovascular cores showed lymphoplasmacytic infiltrates.

Placental Transmogrification of the Lung: A Brief Case Report.: Eun Su Park, Joungho Han, Won Jung Koh, Kyung Soo Lee, Jhingook Kim, Jinwon Seo, Jiyoung Kim; Korean J Pathol. 2008;42(5):308-310.

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Abstract PDF: Placental transmogrification (PT) is an unusual condition in which the alveoli develop a peculiar villous configuration that resembles the placental villi. We report a rare case of pulmonary PT in a 46-year-old man who presented with multiple cystic lesions and nodules on radiography. The patient was treated with a surgical excision. The cut surface of the lung lesion had a villous spongiform manifestation with a partly yellow granular appearance. Microscopically, multiple papillary cores mimicking the villous structures of the placenta were observed within the bullous airspaces. These papillary cores contained many vascular structures, lymphoid aggregates, interstitial clear cells, mature fat and dystrophic calcification. This case was solitary and not associated with other pulmonary or systemic diseases. The etiology is unknown, and further studies will be needed to understand the pathogenesis of the lesion.

Solitary Pulmonary Lymphangioma in an Adult: A Brief Case Report.: Hye Jong Song, Joungho Han, Kwhanmien Kim, Kyung Soo Lee, Jinwon Seo; Korean J Pathol. 2008;42(2):125-127.

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Abstract PDF: Solitary pulmonary lymphangiomas are extremely rare. We report here on an unique case of solitary pulmonary lymphangioma in an adult. A well-circumscribed, 6 cm-sized, pleural based lesion with fluid attenuation was found in a 50-year-old Korean male. He had no previous history of disease or trauma. The wedge-resected lung revealed an ill-demarcated lesion with multiple microscopic cysts and the cystic walls had loose intervening stroma.

Giant Retroperitoneal Lipomatous Angiomyolipoma Simulating Liposarcoma: A Brief Case Report.: Dakeun Lee, Joungho Han, Sung Joo Kim, Dongil Choi; Korean J Pathol. 2007;41(6):406-408.

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Abstract PDF: Extrarenal retroperitoneal angiomyolipomas (AML) are extremely rare, therefore they may present a diagnostic challenge. In this paper, the authors describe a case of a huge retroperitoneal AML in a 49-year-old woman who presented with sudden abdominal pain. Computed tomography revealed the presence of a large, round, fatty mass in the retroperitoneal space, which was easily removed by surgery. The mass was well encapsulated and dark yellow on the cut surface. Microscopically, the tumor was exclusively composed of adipose tissue with frequent multivacuolated, lipoblast-like cells masquerading as well differentiated liposarcoma. In addition, there were many clear, epithelioid cells present, especially around the small blood vessels, which were reactive for HMB-45 and smooth muscle actin.

Inflammatory Pseudotumor of the Paratesticular Area: A Case Report.: Na Rae Kim, Seung Yeon Ha, Jae Gul Chung, Joungho Han; Korean J Pathol. 2004;38(3):208-211.

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Abstract PDF: Inflammatory pseudotumors of the paratesticular area are rare, and are often reported in the literature by various terms, e.g., proliferative funiculitis, inflammatory myofibroblastic tumor, pseudosarcomatous myofibroblastic proliferation and fibrous pseudotumor. This is one of the most common lesions of that region, and typically presents as a longstanding, painless scrotal mass. Here, we describe a 34 year-old man who has had a palpable scrotal mass for the past 10 years. The excised mass was composed of multiple conglomerated nodules, which had homogeneous rubbery cut surfaces. Histologically, each was a well circumscribed, but unencapsulated mass of hyalinized collagenous tissue interspersed with lymphoplasmacytic cells and lymphoid follicle formation. A small fraction of paucicellular spindle cells was positive for vimentin, smooth muscle actin and CD68. Ultrastructurally, abundant collagen fibrils were mixed with paucicellular spindle cells and inflammatory cells. These spindle cells had abundant rough endoplasmic reticula and myofilaments with focal densities, indicating myofibroblastic differentiation.

Expression of the Thyroid Transcription Factor-1 in Carcinomas of Salivary Gland Type and Pulmonary Adenocarcinomas.: Jong Sun Choi, Jeong Wook Seo, Jin Won Seo, Joungho Han; Korean J Pathol. 2003;37(3):180-185.

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Abstract PDF: BACKGROUND
Carcinomas of salivary gland type (CSGT) in the low respiratory tract are rare and often difficult to differentiate from pulmonary adenocarcinomas, which are more common and more aggressive than CSGT, especially in the biopsy specimens. Thyroid transcription factor-1 (TTF-1) is a tissue-specific transcription factor expressed in the thyroid gland and the lung. The purpose of this study is to elucidate the diagnostic utility of TTF-1 in discerning CSGT from adenocarcinomas in the low respiratory tract.
METHODS
Immunohistochemical expression of TTF-1 was investigated in 14 CSGT (9 mucoepidermoid carcinomas and 5 adenoid cystic carcinomas) and 19 adenocarcinomas (5 well differentiated, 12 moderately differentiated and 2 poorly differentiated).
RESULTS
Normal alveolar cells as well as bronchial epithelial cells showed the immunoreactivity for TTF-1, but not in the bronchial glands. In tumors, immunoreactivity for TTF-1 was identified in 17 out of 19 cases of adenocarcinomas (89%), but in none of 14 cases of CSGT. In adenocarcinomas, the immunoreactivity for TTF-1 was strongly correlated with the degree of differentiation (p<0.001).
CONCLUSIONS
These results suggest that TTF-1 can be a valuable marker in distinguishing CSGT from adenocarcinomas of the low respiratory tract.

Isolated Pulmonary Cryptococcosis: Report of Six Cases and Review of the Korean Cases.: Na Rae Kim, Seung Yeon Ha, Dong Hae Chung, Joungho Han, Kyung Soo Lee, O Jung Kwon, Kwan Min Kim; Korean J Pathol. 2003;37(3):193-198.

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Abstract PDF: BACKGROUND
Isolated pulmonary cryptococcosis is uncommon, and it can be seen in both immunocompetent and immunocompromised individuals. In Korea, twenty cases have been described thus far.
METHODS
We report six additional cases of isolated pulmonary cryptococcosis, which were diagnosed by surgical biopsies or fine needle aspiration cytology. We also reviewed the clinicoradiologic and pathologic findings of all the previously published Korean cases of isolated pulmonary cryptococcosis.
RESULTS
Only two patients out of six cases exhibited mild cough and/or fever. Radiologically, three cases presented with multiple subpleural nodules, two with a solitary pulmonary nodule, and one with patchy pneumonic infiltration. On systemic steroid therapy, one case was in severe immunocompromised status at the time of the diagnoses; but three cases had histories of gastric or uterine cervix carcinomas, raising the initial clinical impression of hematogeneous pulmonary metastatic nodules, and one case was accompanied by synchronous pulmonary adenocarcinoma. After reviewing all twenty-six cases of isolated pulmonary cryptococcosis (twenty reported in Korea and our six additional cases), the most common radiologic finding was solitary pulmonary nodule (50%), followed by subpleurally located, multiple nodules (26.9%), pneumonic infiltrates (19.2%), and pleural effusion with thickened pleura (3.8%). Two cases were also accompanied by hilar lymphadenopathy (7.7%). Clinically, presenting symptoms varied: 18 of 26 cases (69.2%) were accompanied by cough and mild fever, but 8 of 26 cases (30.8%) were entirely asymptomatic.
CONCLUSIONS
Since isolated pulmonary cryptococcosis presents itself with nonspecific clinicoradiologic findings, early recognition and differentiation from malignant tumors and pulmonary tuberculosis -the most common causes of solitary pulmonary nodules in Korea- are important to avoiding unnecessary treatment.

Immunoexpressions of Thyroid Transcription Factor-1 and bcl-2 in Congenital Cystic Adenomatoid Malformation.: Na Rae Kim, Dong Hoon Kim, Gou Young Kim, Dae Shick Kim, Joungho Han; Korean J Pathol. 2003;37(1):10-14.

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Abstract PDF: BACKGROUND
Congenital cystic adenomatoid malformation (CCAM) is a congenital abnormality of branching morphogenesis of the lung. Thyroid transcription factor-1 (TTF-1) is detected in human respiratory epithelial cells from 11 weeks of gestation, and at full term, TTF-1 expression is confined within type II epithelial cells and in some respiratory nonciliated bronchiolar epithelial cells. Immunoexpression of bcl-2 is intimately related to apoptosis during the development.
METHODS
To elucidate the nature of the lesion, TTF-1 expression was evaluated in twenty-four cases of CCAM (eight cases of type 1 and sixteen cases of type 2) along with immunostaining for bcl-2. For the control group, four cases of fetal lungs (19 week-, 21 week-, 27 week- and 40 week-gestational age) were also evaluated. In all cases of CCAM, TTF-1 was detected in the nuclei of epithelial cells lining the cysts.
RESULTS
TTF-1 was expressed in the majority of the bronchiolar-like epithelial cells of the cysts in CCAM types 1, and 2, where almost 100% of the lining cells of the cysts were TTF-1 positive with variable intensity, while negative TTF-1 expressions were found in the alveolar-like epithelium of the adjacent alveoli or distal nonciliated bronchi. For bcl-2 immunostaining, no lining epithelial cells of the cysts were stained except for the infiltrating lymphocytes. In the control group, strong immunoreactivities found in early fetal stages were absent in the full-term aged lung (40 gestational weeks).
CONCLUSION
These results support the hypothesis that CCAM types 1 and 2 reflect the abnormalities in lung morphogenesis and differentiation that are distinct from those for normally developed alveolar epithelium or adjacent bronchial epithelium, thus retaining the abnormal TTF-1 immunoreactions. Though restricted to CCAM types 1 and 2 in this study, CCAM might be related to TTF-1 rather than apoptosis in the morphogenesis of the developing lung.

Fatal Strongyloidiasis with Residual Cutaneous Larvae: An Autopsy Case Report.: Na Rae Kim, Dae Su Kim, Joungho Han, Dong Cheol Choe; Korean J Pathol. 2002;36(4):266-270.

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Abstract PDF: Strongyloides stercoralis hyperinfection in immunocompromised patients is difficult to control due to delayed diagnosis, especially in nonendemic areas. A 70-year-old diabetic woman came in with an intermittent diarrhea. She received massive steroid therapy for a week under the impression of idiopathic gastrointestinal eosinophilic syndrome. Diagnosis of strongyloidiasis was made by demonstration of filariform larvae in two repeated sputum specimens two months later. Despite massive administration of albendazole, she died of diabetic ketoacidosis and septic shock. Autopsy revealed a diffusely thickened bowel wall, superimposed invasive pulmonary aspergillosis and the near total destruction of the lungs. Filariform larvae were detected only in the cutaneous lesions. It was presumed that Strongyloides stercoralis hyperinfection was caused by autoinfection in the patient's immunosuppressed status. The present case has two clinical importances; first, intensive treatment with albendazole could erradicate parasites except for the skin but sepsis presumably occurred due to a hypersensitivity reaction against liberated endotoxins during the death of the parasites by the drug. Second, cutaneous parasitic lesion resists the intensive antihelminthic treatment in an immunocompromised host.

Morphologic Characterization of Polycystic Kidney in inv Transgenic Mouse.: Yeon Lim Suh, Mi Kyung Kim, Joungho Han; Korean J Pathol. 1998;32(7):479-487.

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Abstract: The aim of this study was to characterize the morphology of a polycystic kidney which was found in 100% of the transgenic mice homozygous for inv mutation and to gain insight into the pathogenesis of inherited polycystic kidney disease during the pre- and postnatal periods. The fetal and postnatal kidneys from the homozygous and heterozygous transgenic mice were examined by the light, transmission and scanning electron microscopes, image analyzer, and an immunohistochemistry utilizing the antibodies specific for each segment of the renal tubules (Tetragonolobus purpureas, Arachis hypogaea, Tamm-Horsfall protein, AE1/AE3, EMA, vimentin, Phaseolus vulgaris) was performed to determine the site of origin of renal cysts. Two developmental phases of a cystic disease were identified. The first phase, seen in fetal kidneys, was characterized by dilatation mainly of the proximal tubules and a few distal tubules. The later phase, in postnatal period, was characterized by progressive enlargement of the kidneys due to mainly cystic change of the collecting ducts, which distorted the normal architecture of both cortex and medulla and almost completely replaced the renal parenchyma. The cystic dilatation involved all segments of the nephron and the collecting duct as well as the Bowman's spaces of glomeruli. The epithelial cell hyperplasia was found as a micropolyp formation within the renal cysts and an increase in PCNA positive cells. These findings suggest that a cyst is not simply a ballooning of a renal tubule and the stretching of cells, formerly thought to be due to an altered compliance of an abnormal basement membrane, but indeed the result of increased numbers of tubular epithelial cells.

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