Journal of Pathology and Translational Medicine

Seung Yeon Ha

31 Articles

Solitary Fibrous Tumor of the Conjunctiva with Heretofore Undescribed Pathologic Findings.: Na Rae Kim, Jae Y Ro, Kyung Hwan Shin, Hae Jung Paik, Jung Suk An, Seung Yeon Ha; Korean J Pathol. 2011;45(3):315-318.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.3.315

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A 37-year-old female presented with a conjunctival mass discovered 3 years prior. An excisional biopsy revealed a patternless proliferation of round and spindle-shaped cells with an eosinophilic fibrillary cytoplasm and vesicular nuclei with occasional inclusions. Psammoma bodies were arranged around the dilated irregularly-shaped vessels. Differential diagnoses included conjunctival solitary fibrous tumor (SFT), nevus, glomangioma, ectopic meningioma, and mesectodermal leiomyoma. The tumor cells were immunoreactive for CD34, CD99, bcl-2 and vimentin, and were negative for smooth muscle actin, desmin, glial fibrillary acidic protein, S-100 protein, epithelial membrane antigen, and human melanoma black-45. Ultrastructurally, the tumor cells had rough endoplasmic reticulum, free ribosomes, and scattered mitochondria without basal lamina or cellular junctions, which are features of fibroblasts. A diagnosis of SFT was rendered based on the light microscopic, immunohistochemical, and electron microscopic findings. We report here on the second case of a SFT arising in the conjunctiva, which clinically and histologically mimics conjunctival nevus, glomangioma, ectopic meningioma, and a hybrid neurogenic-myogenic tumor such as mesectodermal leiomyoma.

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Meningeal Solitary Fibrous Tumors with Delayed Extracranial Metastasis
Nayoung Han, Hannah Kim, Soo Kee Min, Sun-Ha Paek, Chul-Kee Park, Seung-Hong Choi, U-Ri Chae, Sung-Hye Park
Journal of Pathology and Translational Medicine.2016; 50(2): 113. CrossRef

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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Abstract PDF

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

Morphometric Analysis for Pulmonary Small Cell Carcinoma Using Image Analysis.: Sun Min Jeong, Seung Yeon Ha, Jungsuk An, Hyun Yee Cho, Dong Hae Chung, Na Rae Kim, Sanghui Park; Korean J Pathol. 2011;45(1):87-91.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.1.87

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Abstract PDF

BACKGROUND
There are few studies of how to diagnose small cell lung cancer in cytological tests through morphometric analysis. We tried to measure and analyze characteristics of small cell carcinoma in lung by image analysis.
METHODS
We studied three types of cytologic specimens from 89 patients who were diagnosed with small cell lung cancer by immunohistochemistry. We measured area, perimeter, maximal length and maximal width of cells from small cell carcinoma using image analysis.
RESULTS
In lung aspirates, the nuclear mean area, perimeter, maximal length and maximal width of small cell lung cancer were 218.69 microm2, 55 microm, 18.48 microm and 14.65 microm. In bronchial washings, nuclear measurements were 194.66 microm2, 50.07 microm, 16.27 microm and 14.1 microm. In pleural fluid, values were 177.85 microm2, 48.09 microm, 15.7 microm and 13.37 microm.
CONCLUSIONS
Nuclear size of small cell lung carcinoma is variable and depends on the cytology method. Nuclei are spindle-shaped and larger in small cell carcinoma from lung aspirates than in bronchial washings or pleural fluid. The cytoplasms of the cells in bronchial washings and pleural fluid were swollen. Therefore, one should consider morphologic changes when trying to diagnose small cell lung cancer through cytological tests.

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Interobserver Variability in Diagnosing High-Grade Neuroendocrine Carcinoma of the Lung and Comparing It with the Morphometric Analysis
Seung Yeon Ha, Joungho Han, Wan-Seop Kim, Byung Seong Suh, Mee Sook Roh
Korean Journal of Pathology.2012; 46(1): 42. CrossRef

Cytologic Findings of Alveolar Soft Part Sarcoma Presenting with Multiple Pulmonary Masses: A Case Report with Review of Literature.: Na Rae Kim, Jae Y Ro, Eun Kyung Cho, Mi Jin Kim, Jungsuk An, Seung Yeon Ha; Korean J Pathol. 2011;45(1):119-124.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.1.119

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Abstract PDF

Alveolar soft part sarcoma (ASPS) is a rare malignant soft tissue tumor of uncertain origin, and it has a strong propensity for metastasis to the lungs, bones and brain. We report upon an unusual case of ASPS, presenting as multiple lung nodules with no other detectable primary site, in a 44-year-old man. A fine needle aspiration of the nodules yielded scattered, discohesive cells, each containing an eccentrically displaced nucleus and prominent nucleolus, on a granular background. Tumor cells with numerous bared nuclei, and occasional sheets of epithelioid cells were also found. Under the cytological diagnosis of an unclassified epithelioid malignant tumor, resection of the lung nodules was performed. The histologic findings were consistent with ASPS, showing positive TFE3-nuclear immunoreactivity. There is limited literature concerning cytological findings associated with pulmonary ASPS: especially in cases where the primary site is unknown. Here, we present a cytological review of pulmonary ASPS, investigating the significance of TFE3 staining in the diagnosis of ASPS.

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Alveolar soft part sarcoma: A case report with emphasis on some unusual cytological features
Neelam Sood, Minakshi Gulia
Diagnostic Cytopathology.2018; 46(2): 170. CrossRef

Practical Standardization in Renal Biopsy Reporting.: So Young Jin, Hyeon Joo Jeong, Sun Hee Sung, Beom Jin Lim, Jee Young Han, Soon Won Hong, Hyun Ee Yim, Yeong Jin Choi, Yong Mee Cho, Myoung Jae Kang, Kyung Chul Moon, Hee Jeong Cha, Seung Yeon Ha, Mi Seon Kang, Mee Young So, Kwang Sun Suh, Jong Eun Joo, Yong Jin Kim, Nam Hee Won, Moon Hyang Park; Korean J Pathol. 2010;44(6):613-622.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.6.613

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BACKGROUND
To standardize renal biopsy reporting and diagnosis, The Renal Pathology Study Group of the Korean Society of Pathologists (RPSKSP) has developed a renal pathology reporting format for the native and allograft kidney.
METHODS
A consensus checklist of a provisional renal biopsy format was sent to all members of the RPSKSP. Feed back opinions regarding the practical application of the checklist to the diagnostic work were received.
RESULTS
Kidney biopsies require three essential examinations: by light microscopy, immunofluorescence (IF), and electron microscopy (EM). A final report of a renal biopsy should include information on specimen adequacy and a description of the morphologic change using a systematic semiquantitative method for each of the compartments, with optional separate IF and EM reports.
CONCLUSIONS
A standard renal biopsy report format is important in establishing clinicopathologic correlations, making reliable prognostic considerations, comparing the findings in sequential biopsies and evaluating the effects of therapy.

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Additional antihypertensive effect of magnesium supplementation with an angiotensin II receptor blocker in hypomagnesemic rats
Kyubok Jin, Tae Hee Kim, Yeong Hoon Kim, Yang Wook Kim
The Korean Journal of Internal Medicine.2013; 28(2): 197. CrossRef
Clinicopathologic Features of IgA-Dominant Postinfectious Glomerulonephritis
Tai Yeon Koo, Gheun-Ho Kim, Hyang Park
Korean Journal of Pathology.2012; 46(2): 105. CrossRef

The Fine Needle Aspiration Cytology of a Metastatic Pulmonary Adrenocortical Carcinoma Mimicking Primary Large Cell Carcinoma of the Lung.: Na Rae Kim, Dong Hae Chung, Jae Ik Lee, Seung Yeon Ha; Korean J Pathol. 2010;44(5):558-563.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.5.558

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Abstract PDF: Adrenocortical carcinoma is a rare neoplasm and it has an invariably lethal prognosis. We report here on the fine needle aspiration cytologic findings of a solitary metastatic pulmonary adrenocortical carcinoma in a 24-year-old woman. The aspirate smears were very cellular and they were composed of a monomorphic population of large polyhedral cells with abundant granular or vacuolated cytoplasm, and the cells were predominantly singly scattered in a necrotic background. Multinucleated pleomorphic tumor cells were also found. Pleomorphic nuclei with thickened nuclear membranes were impinging on the cell membranes. Mitotic activity was occasionally seen. The cytologic findings of pleomorphic cells with microvacuolated cytoplasm and the presence of vague gland-like sheets, as well as the patient's history of undergoing adrenalectomy for primary adrenocortical carcinoma helped the pathologist reach the diagnosis of metastatic adrenocortical carcinoma. Here, we focus on the cytologic differential points of metastastic pulmonary adrenocortical carcinoma and primary pulmonary carcinoma, especially large cell carcinoma.

The Analysis and Clinical Usefulness of HPV DNA Chip Test in the Uterine Cervix.: Joo hyeon Jeong, Hyun Yee Cho, Na Rae Kim, Dong Hae Chung, Sanghui Park, Seung Yeon Ha; Korean J Pathol. 2010;44(1):77-82.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.1.77

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Abstract PDF

BACKGROUND
The genotypes of human papillomavirus (HPV) are important in carcinogenesis in uterine cervical cancer and may be different in geographic distribution.
METHODS
In 2,086 women, we analyzed the prevalence of HPV and HPV genotypes in uterine cervix by HPV-DNA chip test (n = 2,086), cytology (PAP smear, n = 1997) and biopsy (n = 546).
RESULTS
Of the 2,086 cases, 1,019 cases (48.8%) were HPV-positive and 1,067 cases (51.2%) were negative for HPV. Single infection occurred most commonly (72.1% of women). HPV genotypes in the high-risk and low-risk groups, respectively were HPV-16/-58/-18/-52/-53 and HPV-70/-6/-11. The detection rates of HPV-70 in subjects older than 50 years increased significantly (p < 0.05). Infection in high risk subjects was detected in high grade lesions compared with infection in low risk subjects (p < 0.05).
CONCLUSIONS
HPV-16/-58/-18/-52/-53/-70/-6/-11 genotypes were common in the patient group similar to findings in East Asia. HPV-70 infection is predominant in those older than 40 years.

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Current Status of and Perspectives on Cervical Cancer Screening in Korea
Sung-Chul Lim, Chong Woo Yoo
Journal of Pathology and Translational Medicine.2019; 53(4): 210. CrossRef
Cervical cytology of atypical squamous cells, cannot exclude high-grade squamous intra-epithelial lesion: significance of age, human papillomavirus DNA detection and previous abnormal cytology on follow-up outcomes
Chang Ohk Sung, Young Lyun Oh, Sang Yong Song
European Journal of Obstetrics & Gynecology and Reproductive Biology.2011; 159(1): 155. CrossRef
Cytomorphologic Features According to HPV DNA Type in Histologically Proven Cases of the Uterine Cervix
In Ho Choi, So-Young Jin, Dong Wha Lee, Dong Won Kim, Yoon Mi Jeen
The Korean Journal of Pathology.2011; 45(6): 612. CrossRef

Ovarian Endometrioid Adenocarcinoma with a Yolk Sac Tumor Component.: Dong Hae Chung, Sanghui Park, Hee Eun Kyung, Na Rae Kim, Seung Yeon Ha, Soyi Lim, Hyun Yee Cho; Korean J Pathol. 2009;43(6):570-574.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.6.570

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Abstract PDF: Ovarian endometrioid adenocarcinoma (EAC) with a yolk sac tumor (YST) component is extremely rare. Only twelve cases have been reported in the English literature. We report here two additional cases of this rare tumor. The YST component showed classic microscopic features, and immunohistochemically stained positive for alpha-fetoprotein (AFP), but negative for cytokeratin 7 (CK7), epithelial membrane antigen (EMA), estrogen receptor (ER) and progesterone receptor (PR). The EAC appeared to blend into the YST in several areas and immunohistochemically stained positive for CK7, EMA, ER, and PR, but negative for AFP.

Malignant Peripheral Nerve Sheath Tumors of the Bilateral Adrenal Glands: Are They Metachronous Primary Tumors: A Case Report.: Jae Hong Park, Seung Yeon Ha, Hyun Yee Cho; Korean J Pathol. 2009;43(5):471-474.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.5.471

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Abstract PDF: Malignant peripheral nerve sheath tumors (MPNSTs) have rarely been reported to occur in the adrenal gland and all of the reported cases were associated with neurofibromatosis, pheochromocytoma or ganglioneuroma. We present here a case of MPNST in the bilateral adrenal glands without any history of neurofibromatosis or combined tumor. Histologic examination showed the tumor cells had a spindle to ovoid shape, they were arranged in sweeping fascicles and there were frequent mitotic figures. The immunohistochemical and ultrastructural features of the tumor are also presented. To the best of our knowledge, this is the first report in the English medical literature about MPNSTs in the bilateral adrenal glands without any history of neurofibromatosis or combined tumor.

Eosinophilic Fasciitis Associated with Overlying Intraepidermal Blister Formation: A Case Report.: Na Rae Kim, Dong Hae Chung, Seung Yeon Ha; Korean J Pathol. 2009;43(5):478-481.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.5.478

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Abstract PDF: Eosinophilic fasciitis is a scleroderma-like disease and it may present with paraneoplastic syndrome or as an isolated form of the disease. We report here on a case of eosinophilic fasciitis in a 20-year-old woman who presented with an abrupt onset of subcutaneous limb swelling and peripheral eosinophilia. Pathologically, the specimen was characterized by acute inflammation and thickening of the collagen bundles in the reticular dermis and superficial muscle fascia in addition to the overlying intraepidermal blisters that contained many eosinophils. Eosinophils, some lymphocytes and plasma cells were infiltrated in the superficial muscle fascia and subcutaneous fat. The diagnosis of eosinophilic fasciitis was confirmed by biopsy. It is intriguing that eosinophilic fasciitis showed the microscopic findings of intraepidermal blister with predominant inflammation, and the patient showed a good response to steroid therapy.

Cytology of Plasmacytoid Type Myoepithelioma: Report of Two Cases.: Na Rae Kim, Hyun Yee Cho, Seung Yeon Ha; Korean J Pathol. 2009;43(5):489-493.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.5.489

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Abstract PDF

Myoepithelioma is a rare benign tumor of salivary gland myoepithelial cells, most commonly as a spindle subtype. Here, we present two cases of fine needle aspiration cytology of plasmacytoid myoepithelioma arising from a parotid gland and a hard palate. Aspirates showed plasmacytoid cells with pink-staining, homogeneous, abundant eosinophilic cytoplasm eccentrically displacing the nucleus in cohesive and dissociated forms. Rarely, nuclear grooves and intranuclear cytoplasmic inclusions were evident. These unfamiliar cytologic findings of uncommon myoepithelioma often cause diagnostic difficulties in preoperative aspiration cytology. Recognition of those rare findings provides a reliable diagnostic clue.

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Plasmacytoid myoepithelioma: Diagnostic algorithm and a tailored therapeutic protocol for a geriatric individual
Pratik N. Patel, Aatish Thennavan, Venkadasalapathy Narayanaswamy, Raghu Radhakrishnan
Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology.2015; 27(5): 737. CrossRef
Imprint Cytology of Soft Tissue Myoepithelioma: A Case Study
Seok Ju Park, Ae Ri Kim, Mi Jin Gu, Joon Hyuk Choi, Duk Seop Shin
Korean Journal of Pathology.2013; 47(3): 299. CrossRef
Fine Needle Aspiration Cytology of Benign Salivary Gland Tumors with Myoepithelial Cell Participation: An Institutional Experience of 575 Cases
Soomin Ahn, Yuil Kim, Young Lyun Oh
Acta Cytologica.2013; 57(6): 567. CrossRef
Plasmacytoid Myoepithelioma of the Palate: Case Report
Matina T. Zormpa, Asimina S. Sarigelou, Anna N. Eleftheriou, Anthoula S. Assimaki, Alexandros E. Kolokotronis
Head and Neck Pathology.2011; 5(2): 154. CrossRef

The Usefulness of the HPV DNA Microchip Test for Women with ASC-US.: Hee Eun Kyeong, Seung Yeon Ha, Dong Hae Chung, Na Rae Kim, Sanghui Park, Hyun Yee Cho; Korean J Pathol. 2009;43(3):254-259.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.3.254

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Abstract PDF

BACKGROUND
This study was performed to ascertain the usefulness of the human papillomavirus (HPV) DNA microchip test for the screening and management of women with atypical squamous cells of undetermined significance (ASC-US).
METHODS
The subject group consisted of 534 patients, and all of whom were diagnosed as ASC-US according to a Papanicolaou smear, and they all underwent concomitant HPV DNA microchip test.
RESULTS
The occurrence rates of overall squamous lesions and high risk lesion (cervical intraepithelial neoplasia grade 2 and grade 3, and invasive carcinoma) of the HPV-positive ASC-US patients were significantly higher than those of the HPV-negative ASC-US patients. High risk lesion was detected more frequently among the older patients and the patients with HPV 56, 33 or 70. On the follow-up HPV DNA microchip test, only 1 of 11 (9.1%) HPV type-switched women developed squamous lesion compared with 8 of 13 (61.6%) HPV type-persistent women who developed squamous lesion.
CONCLUSIONS
The HPV DNA microchip test is useful for the management of ASC-US patients. HPV-positive ASC-US patients should undergo a HPV DNA microchip test periodically. If the same genotype of HPV is persistent on the follow-up test, more increased surveillance is needed.

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Enhanced disease progression due to persistent HPV-16/58 infections in Korean women: a systematic review and the Korea HPV cohort study
Jaehyun Seong, Sangmi Ryou, JeongGyu Lee, Myeongsu Yoo, Sooyoung Hur, Byeong-Sun Choi
Virology Journal.2021;[Epub] CrossRef

Age Estimation of Mummies by Dental Attrition: Application of Three-dimensional CT Images.: Kwang Ho Jeong, Han Kyeom Kim, Chang Lyuk Yoon, Seong Jae Lee, Seung Yeon Ha; Korean J Pathol. 2008;42(5):299-305.

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Abstract PDF: BACKGROUND
Because of the rarity of mummies in Korea and the difficulty in obtaining samples from mummies, studies to determine the ages of mummies are uncommon in Korea. This study was performed to determine the ages of mummies using the information obtained by nondestructive methods to minimize damages to the mummies. METHODS: Three mummies excavated between 2002 and 2004 were used. Three-dimensional reconstructed images of the total teeth were obtained by CT scanning. The age at death was determined according to the 'Age Estimation Table of Dental Attrition' as developed by Takei. Three teeth were extracted from each of three mummies and examined grossly and microscopically by serial sections using the Gustafson-Johanson method. RESULTS: The ages at death of the three mummies estimated by the Takei method were 23.57 years (Yoon mummy), 51.01 years (Bong mummy), and 64.45 years (Black mummy). These results were similar to the ages determined by the Gustafson method. CONCLUSION: Age determination method using a CT scan and three-dimensional reconstruction may be a valuable method because it minimizes the damages to valuable mummies and it gives reliable data similar to that obtained by other standard methods.

Birefringent Particles as an Effective Factor in Usual Interstitial Pneumonia.: Min Jung Kim, Seung Yeon Ha, Sung Hwan Jeong, Bongkyung Shin; Korean J Pathol. 2008;42(4):198-201.

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Abstract PDF: BACKGROUND
It has long been recognized that birefringent paticles (BP) are associated with pulmonary disease. And there is increasing evidence that BP cause fibrotic reaction within the lung depending on both particle size and composition.
METHODS
We collected 41 cases of usual interstitial pneumonia (UIP) and 101 cases of normal lung tissue from control group including squamous cell carcinoma, adenocarcinoma and bullae. BPs in the 0.1 to 10 micrometer size range under polarizing microscope was measured and counted by image analyzer.
RESULTS
BP counts are mean 244.05/10 HPF in UIP and 71.4/10 HPF in control group. BPs in UIP is three times more than control (p=0.000). It increased significantly by the age of patients (p=0.000).
CONCLUSIONS
BPs in lung might be important cause of inflammation and fibrosis in UIP.

The Usefulness of Cervicovaginal Cytology as a Primary Screening Test.: Jae Hong Park, Seung Yeon Ha, Hyun Yee Cho, Dong Hae Chung, Na Rae Kim, Sanghui Park; Korean J Cytopathol. 2008;19(2):107-110.; DOI: https://doi.org/10.3338/kjc.2008.19.2.107

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Abstract PDF

We evaluated the usefulness of cervicovaginal cytology as a primary screening test by analyzing the cytologic and histological diagnoses of 2,254 women. Cervicovaginal cytology had 93.0% sensitivity, 86.1% specificity, 88.2% positive predictive value, and 91.7% of negative predictive value. Cervicovaginal cytology as a primary screening test showed much higher specificity but slightly lower sensitivity than HPV DNA testing. However, the sensitivity of cervicovaginal cytology will be improved continuously due to the development of liquid-based cytology. We regard cervicovaginal cytology as a good primary screening test for cervical intraepithelial neoplasia or carcinoma.

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Working Conditions that Impact the Workload of Cytotechnologists: A Study Calculating the Actual Man Power Required
Soo Il Jee, Yong Ho Ahn, Hwa-Jeong Ha, Jeong Eun Kang, Jun Ho Won
The Korean Journal of Clinical Laboratory Science.2021; 53(2): 174. CrossRef

Pulmonary Adenocarcinoma with a Micropapillary Pattern Detected by Bronchial Washing: A Brief Case Report.: Jae Hong Park, Seung Yeon Ha, Hyun Yee Cho, Dong Hae Chung, Na Rae Kim, Sanghui Park; Korean J Cytopathol. 2008;19(2):206-208.; DOI: https://doi.org/10.3338/kjc.2008.19.2.206

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Abstract PDF: Adenocarcinomas with micropapillary patterns are generally aggressive and show lymphotropism. Only a few reports on pulmonary adenocarcinoma with micropapillary patterns have described cytologic findings. A 70-year-old Korean woman was admitted to the hospital because of intermittent dry cough and chest pain. Cytology after bronchial washing showed neoplastic cells in small, angulated, cohesive clusters consisting of 3-20 cells without a fibrovascular core. The resected right middle lobe showed a tumor occupying almost the entire lobe. Histologically, about 90% of neoplastic cells proliferated with micropapillary morphology in the background of bronchioloalveolar carcinoma. Cytologic smears of a bronchial washing showing tumor cells in small, cohesive clusters without a fibrovascular core may indicate an adenocarcinoma with micropapillary pattern.

Meningioma Arising from Meningioangiomatosis Without Neurofibromatosis: A Case Report.: Jae Hong Park, Seung Yeon Ha, Na Rae Kim; Korean J Pathol. 2007;41(4):263-265.

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Abstract PDF: We report a rare case of meningioma associated with meningioangiomatosis in a 9-year-old male patient who showed none of the stigmata of neurofibromatosis 2. Brain magnetic resonance images showed marked cortical calcification with slight contrast-enhancement in the parieto-occipital lobe. The resected mass showed that the lesion was mainly composed of meningioangiomatosis and a small focus was transformed into meningioma. To date, only 17 cases of such combined lesions have been reported in English medical literature. We report a rare case of meningioma that arose from meningioangiomatosis.

Fine Needle Aspiration Cytology of Langerhans Cell Histiocytosis in a Lymph Node: A Case Report.: Seung Yeon Ha, Min Jung Kim, Gou Young Kim, Hyun Yee Cho, Dong Hae Chung, Na Rae Kim; Korean J Cytopathol. 2007;18(1):87-91.

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Abstract PDF: Langerhans cell histiocytosis (LCH) is a pleomorphic disease entity characterized by local or disseminated atypical Langerhans cells (LCs) found most commonly in bone, lungs, mucocutaneous structures and endocrine organs. Among different sites, unifocal disease confined to a lymph node (LN) is rare. We report a case of LCH confined to a LN in a 38-year-old male who presented with a 2 cm-sized cervical mass. The fine needle aspiration (FNA) smears of cervical LN showed high cellularity having isolated LCs with contorted nuclei and nuclear grooves mixed in multinucleated giant cells, small lymphocytes and eosinophils. Charcot-Leyden crystals were also seen, as were a few dendritic-like cells and intranuclear inclusions. Confirmation of LCH was made by histopathologic studies, positive reactions for S-100 protein and CD1a immunohistochemical staining and by the demonstration of Birbeck granules on electron microscopy. The differentials to be considered include dermatopathic lymphadenitis, sinus histiocytosis with massive lymphadenopathy, Hodgkin's lymphoma and malignant histiocytosis. The characteristic cytomorphologic pattern of LCH in a LN FNA smear plays an important role in suggesting the diagnosis of LCH.

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.

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.

Quantitative Nuclear Characteristics of Lung Cancer Cells Using Image Analysis.: Moon Kyoung Kim, Chung Yeul Kim, Woon Yong Jeong, Ji Hye Lee, Eung Seok Lee, Seung Yeon Ha, Young Sik Kim, Han Kyeom Kim, In Sun Kim; Korean J Pathol. 2003;37(2):115-120.

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Abstract PDF: BACKGROUND
The usefulness of quantitative nuclear image analysis in the classification of lung carcinoma is widely investigated and published. In this study, we tried to measure the nuclear characteristics of primary lung carcinomas by image analysis and to find the possibility of differential diagnoses.
METHODS
Seventeen cases of adenocarcinomas (not including bronchioloalveolar carcinoma), seven of bronchioloalveolar carcinomas, eight of large cell neuroendocrine carcinomas, five of small cell carcinamas, and 26 of squamous cell carcinomas were analysed. Three different images of each case were captured by digital camera, and we analyzed the nuclear area, perimeter, circularity, and density using the Optimas 6.5 Image Analyser software package. Statistical analyses were done using the statistical program STATISTICA kernel release 5.5.
RESULTS
The mean nuclear area was 0.52+/-0.25micrometer2 in the adenocarcinomas, 0.50+/-1.82micrometer2 in the squamous cell carcinomas, 0.45+/-0.20micrometer2 in the large cell neuroendocrine carcinomas, 0.42+/-0.16micrometer2 in the bronchioloalveolar carcinomas, and 0.31+/-0.12micrometer2 in the small cell carcinamas. The nuclear area was significantly different between the small cell carcinomas and the non-small cell carcinomas (p<0.01) and between the adenocarcinomas and the bronchioloalveolar carcinomas (p=0.02). The mean nuclear perimeter was 3.36+/-0.92micrometer2 in the adenocarcinomas, 3.24+/-0.67micrometer2 in the squamous cell carcinomas, 3.16+/-0.82micrometer2 in the large cell neuroendocrine carcinomas, 3.05+/-0.80micrometer2 in the bronchioloalveolar carcinomas, and 2.54+/-0.62micrometer2 in the small cell carcinamas. The nuclear perimeter was significantly different between the small cell carcinomas and the non-small cell carcinomas (p<0.04). The nuclear circularity showed no statistical difference. Nuclear density was the highest in the squamous cell carcinomas, and the lowest in the small cell carcinomas. The large cell neuroendocrine carcinomas showed the lowest standard deviation in nuclear density.
CONCLUSION
The analysis of nuclear characteristics using an image analyser can be used as an objective method in the classification of lung carcinoma.

Cytologic Features of Signet Ring Cell Carcinoma of the Uterine Cervix: A Report of Two Cases.: Hyun Yee Cho, Seung Yeon Ha, Jaegul Chung, Young Ha Oh, Dong Hae Chung, Na Rae Kim, Jong Min Lee, Eui Don Lee; Korean J Cytopathol. 2003;14(2):66-70.

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Abstract PDF: Signet ring cell carcinoma is a rare type of mucinous adenocarcinoma of the uterine cervix. To the best of our knowledge, there is no report on cytologic findings of primary signet ring cell carcinoma of the uterine cervix in the literature. Recently, we experienced two cases of signet ring cell carcinoma of the uterine cervix. The finding of characteristic signet ring cells on cervicovaginal smear led to the diagnosis of signet ring cell carcinoma. However, primary signet ring cell carcinoma could not be cytologically distinguished from more common metastatic tumor. Therefore, diagnosis rests upon the recognition of signet ring cells and the absence of signet ring cell carcinoma elsewhere.

Plexogenic Pulmonary Arteriopathy in Congenital Heart Disease: A Report of Two Cases.: Seung Yeon Ha, Kook Yang Park, Hyun Yee Cho, Young Ha Oh, Jae Gul Chung, Dong Hae Chung, Chung Yeul Kim, Han Kyeom Kim; Korean J Pathol. 2002;36(6):412-415.

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Abstract PDF: Hypertensive pulmonary vascular disease can develop in those cases of congenital cardiac shunt in which critical levels of pulmonary artery pressure and flow are reached and exceeded. We have experienced two cases of plexogenic arteriopathy in complex congenital heart disease and tried to evaluate of distribution of arterial lesions by total mapping of the explanted lung. Case 1 and 2 were 12-year-old boy and 36 year-old man. They were treated with combined heart-lung transplantation. Mapping of the both lungs was done, and graded according to Heath and Edward's grading scheme. The elastic pulmonary artery was tortuous, dilated and aortic configuration. Both lungs showed mostly grade 3. Plexiform lesion or veinlike branches of hypertrophied muscular arteries arosed in a lateral branch of a muscular artery that might be proximal to an area of occlusion. Comprising the right and left lung, the right was more severe than the left. By getting closer to the distal part, the grade tended to increase to 4 to 5. By analyzing the pulmonary lobe, severe pulmonary hypertension of grade 4 or 5 was comparatively disseminated throughout the right lung. On the other hand, in the left lung, the grade of the lower lobe was higher than that of the upper lobe, and within the upper lobe, there was a tendency for the grade of inferior segment to be higher than that of the corresponding apical segment.

Pulmonary Alveolar Proteinosis: A Case Report with Diagnostic Features in Bronchoalveolar Lavage Specimen .: Seung Yeon Ha, Hyuni Cho, Young Ha Oh; Korean J Cytopathol. 2000;11(2):103-108.

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Abstract PDF: Pulmonary alveolar proteinosis(PAP) is a rare disease in which the alveolar spaces are filled with an eosinophilic, PAS-positive material, whereas the interstitial architecture of the lung usually remains unaffected. Although a definitive diagnosis is usually made by an open lung biopsy, bronchoalveolar lavage(BAL) cytology may play a decisive role in the diagnosis and therapy of these patients and may spare a patient a more invasive diagnostic procedure. The author presents a patient in whom BAL cytology specimen contained the characteristic globules of amorphous proteinaceous PAS-positive material accompanied by background of rare macrophages and inflammatory cells. Ultrastructural study using BAL specimen can confirm the diagnosis of PAP.

Fine Needle Aspiration Cytology of Primary Pulmonary Amyloidosis: A Case Report .: Hyuni Cho, Seung Yeon Ha, Young Ha Oh, Seong Hwan Jeong; Korean J Cytopathol. 2000;11(2):99-102.

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Abstract PDF: Pulmonary amyloid deposition generally occurs with concurrent primary systemic amyloidosis. Localized forms of pulmonary amyloidosis are rare and appear most frequently as an incidental finding on chest radiographs. We present a case of nodular pulmonary amyloid tumor suggested by fine needle aspiration cytology (FNAC) and confirmed by histologic examination with the polarizing light microscopy. A 41-year-old woman presented with ill-defined nodules in the middle and lower lobes of both lungs. FNAC of the nodules revealed waxy, acellular amorphous fragments. Thoracotomy for diagnosis may be avoided by FNAC diagnosis of this unusual lesion.

The Cytologic Features of Adenoid Cystic Carcinoma of the Uterine Cervix: A Case Report .: Seung Yeon Ha, Hyuni Cho, Young Ha Oh, Geun Shin Lyu; Korean J Cytopathol. 1998;9(2):207-212.

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Abstract PDF: Adenoid cystic carcinoma of the uterine cervix is a rare tumor accounting for less than 1% of all cervical adenocarcinoma. This tumor is characterized by aggressive biological behavior with frequent local recurrence or metastatic spread, postmenopausal onset, and occasional association with conventional squamous cell carcinoma. The cytologic diagnosis of adenoid cystic carcinoma in the uterine cervix is often difficult because of negative smear due to intact overlying mucosa, cytologic findings mimicking endometrial cells, and masquerade as squamous cell carcinoma. Recently we have experienced a case of adenoid cystic carcinoma arising in the uterine cervix, which was identified on the routine Papanicolaou smear and was histologically confirmed by the consequent biopsy. The smear showed abundant cellularity composed of relatively uniform cells. The tumor cells were arranged in small clusters, acini, naked cells, and loose sheets with abortive cribriform pattern. There were scattered globoid basement membrane-like materials and tumor diathesis. The nuclei were pleomorphic and showed hyperchromatic and coarsely granular choromatin with inconspicuous nucleoli. The punch biopsy of the uterine cervix showed typical histologic findings of adenoid cystic carcinoma characterized by tumor nests composed of hyperchromatic uniform basaloid cells, cribriform pattern, and cylindrical hyaline bodies.

Cytohistologic Features of Chordoma Arising in Thoracic Spine: A Case Report.: Seung Yeon Ha, Insun Kim, Sung Hye Park, Heum Rye Park; Korean J Cytopathol. 1995;6(2):199-203.

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Abstract PDF: Chordoma is relatively uncommon tumor comprising 1~4% of primary malignant bone tumors, and believed to arise from the remnants of notochordal tissue. Because of its occurrence in the thoracic spine, we report a case of chordoma in volving the thoracic spine. A 45-year-old male was suffered from chest pain radiating to the back. Chest CT showed a well marginated, round huge mass with multiseptated enhancement at the thoracic spine from T5 to T8 level, After percutaneous needle aspiration, piecemeal resection of the tumor was done. On cytologic smears. two types of neoplastic cells were arranged in sheets and cords in mucinous background. One type of cells consisted of medium sized cells with pink cytoplasm and round nuclei. The other type had voluminous bubbly or clear cytoplasm divided by intracytoplasmic septae imparting a feathery or basket-like appearance. Histologically, the tumor showed lobulated feature divided by fibrous septae and the tumor cells were pink eosinophilic or physaliphorous in morphology. Immunohistochemically, the tumor cells revealed strong positivity for low(AE1) and high (AE3) molecular weight cytokeratins.

Pulmonary Cavernous Hemangioma: A case report.: Seung Yeon Ha, Sang Ae Yoon, Yang Seok Chae; Korean J Pathol. 1994;28(2):203-205.

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Abstract PDF: The pulmonary cavernous hemangioma is usually from birth and there may be without symptoms until adulthood. Larger or multiple pulmonary angiomata with considerable pulmonary arteriovenous shunts may cause cyanosis, finger clubbing, dyspnea and frequently accompanyingbruit. Recently, we experienced a case of cavernous hemangioma of the lung. A 34-year-old woman was admitted to our hospital for surgical evaluation of a 4 cm solitary, round nodule in the right upper lobe on the chest X-ray and CT scan. She had no symptoms. Laboratory findings are within normal limits except for elevated glucose levels. At surgery, the mass was well encapsulated and easily excised from the peripheral portion of the posterior segment of the right upper lobe. Grossly, it consisted of a 4 cm in diameter, round, soft, sponge-like, hemorrhagic, slightly lobulated mass with a smooth external surface. Microscopically, the mass was composed of vessels, which were thin walled, dilated and filled with blood. The wall of the abnormal vessels was thin and composed of endothelium and fibrous connective tissue with only a little smooth muscle. Immunohistochemically, the wall of the dilated abnormal vessesls showed negative reaction for cytokeratin(low and high) and epithelial membrane antigen but weakly positive reaction for UEA-1 in focal areas.

Leiomyoma of the Lung: A case report.: Seung Yeon Ha, Yung Suk Lee, Won Bo Cho, In Sun Kim; Korean J Pathol. 1993;27(6):673-675.

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Abstract PDF: We present a 37-year-old male who was found to had mas within the bronchus. This patients was admitted for the evaluation of cough. Chest CT scan showed endobronchial mass in the bifurcation of LUL and LLL bronchus. The left lower lobe was atelectatic. Lobectomy of the left lower lobe was done. On opening of the bronchus, there was a 2x1x1 cm sized endobronchial mass. Histologically, the mass was smooth muscle tumor composed of densely packed eosinophilic spindle cells in interlacing bundles with pale elongated nuclei covered by bronchial epithelium. On immunohistochemical staining, the tumor cells were positive for desmin. Ultrastructurally, the tumor cells exhibited numberous cytoplasmic microfilaments with focal densities, pinocytotic vesicles, and a thick basal lamina.

Breast Mass as a Manifestation of Ectopic Paragonimiasis: A case report.: Yung Suk Lee, Seung Yeon Ha, Hyun I Cho, Han Kyeom Kim, Jung Won Bae, In Sun Kim; Korean J Pathol. 1993;27(6):656-658.

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Abstract PDF: Paragonimus westermani can cause extrapulmonary parasitism in various sites such as abdominal organ, brain, eye, periorbital tissue, heart and pericardium, mediastinum, and subcutaneous tissue. We experienced a case of subcutaneous paragonimiasis involving the breast. The lesion exhibited chronic granuloma with scattered eggs of paragonimus westermani. The adult worm was not found within the lesion which should be disintegrated a year ago by praziquantel treatment. This relatively rare involvement of ectopic paragonimiasis should be differentiated from breast malignancy.

Giant Cell Arteritis of the Spermatic Cord.: Seung Yeon Ha, Han Kyeom Kim, In Sun Kim; Korean J Pathol. 1992;26(6):638-640.

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Abstract PDF: Giant cell arteritis is a focal granulomatous inflammation of arteries of medium and small size that affects principally the cranial vessels, especially the temporal arteries, in older individuals. It appears to be a localized process; its significance apparantly depends on the organ affected. A 67-year-old man was admitted to hospital because of the left scrotal mass and pain lasting for 1 month. On physical examination, the hard masses were palpated at the superior part of the left epididymis without tenderness. Histologically, the spermatic cord showed granulomatous arteritis involving the small and medium sized arteries with a transmural inflammatory infiltrates centered on the inner media, and composed of lymphocytes, histiocytes, some eosinophils and multinucleated giant cells. The elastic tissue stain revealed the fragmentation of the internal elastic lamina along with numerous epithelioid histiocytes and giant cells.

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