- Expression of Maspin Protein in Ductal Hyperplasia, Intraductal Carcinoma and Invasive Ductal Carcinoma of the Breast.
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Young Chae Chu, In Seo Park, Yoon Ju Kim, Joon Mee Kim, Hye Seung Han, Jee Young Han, Young Bae Kim
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Korean J Pathol. 1999;33(8):614-619.
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 Abstract
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- 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.
- Cytologic Features of an Angiosarcoma in Pleural Fluid: A Case Report .
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Young Chae Chu, In Seo Park, Yoon Ju Kim, Hye Seung Han, Jee Young Han
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Korean J Cytopathol. 1999;10(1):61-66.
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- 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.
- Malignant Mixed Mullerian Tumor Arising from Adenomyosis of Uterus.
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Yoon Ju Kim, Jung Il Suh
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Korean J Pathol. 1998;32(12):1098-1100.
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Abstract
- Malignant mixed mullerian tumor (MMMT) is an unusual tumor composed of malignant epithelial and nonepithelial components in the same lesion and is subdivided into homologous and heterologous types. Epidemiologically, these tumors are associated with prior pelvic irradiation, functioning ovarian lesions, exogenous estrogen therapy and rarely endometriosis. We experienced a case of uterine MMMT which arose from adenomyosis in a 47-year-old woman who had no specific past medical history. The posterior uterine corpus showed a 3.5x3.0x2.0 cm sized, relatively well defined tumor mass within the background of the adenomyosis.
The tumor was composed of well differentiated endometrial adenocarcinoma and sarcomatous stroma with foci of rhabdomyosarcomatous differentiation confirmed by immunohistochemical and electron microscopic studies.
Through the immunohistochemical study, both the epithelial and nonepithelial components were positive for cytokeratin and it suggested that the sarcomatous area originated from metaplasia of the adenocarcinoma component. From the overall findings, it is regarded as an uterine heterologous MMMT which arose from adenomyosis.
- Bronchus-Associated Lymphoid Tissue Lymphoma.
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Yoon Ju Kim, Sung Sook Paeng, Hee Jin Chang, Jung Il Suh
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Korean J Pathol. 1998;32(11):1035-1038.
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Abstract
- Malignant lymphoma arising from mucosa-associated lymphoid tissue (MALT) represents distinct clinicopathologic features and remains localized for prolonged periods. We report a case of low grade B cell lymphoma of bronchus-associated lymphoid tissue (BALT). A 60-year-old female had a long-standing cough, sputum and intermittent fever for 10 years. In 1984, the chest radiography showed increased hazy density in both upper lungs. Although she had been treated by antituberculous medication under clinical diagnosis, there was no improvement. In 1995, open lung biopsy was carried out. Histologically, it showed massive nodular or diffuse infiltration of centrocyte-like cells in bronchus and parenchyme with pleural invasion. On immunohistochemical stain, they were positive for LN-2 and L26 and negative for UCHL-1, LN-1 and LN-3. In polymerase chain reaction (PCR), Ig heavy chain gene rearrangement was detected. The patient was well for 6 months after the biopsy.
- Syphilitic Granulomatous Pancreatitis: A case report.
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Seong Eun Yang, Yoon Ju Kim, Sung Suk Paeng, Duck Hwan Kim, Hee Jin Chang, Jung Il Suh
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Korean J Pathol. 1996;30(8):721-725.
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- Syphilitic granulomatous pancreatitis is an extremely rare condition,and can occur in the generalized acquired syphilitic patient in tertiary or secondary phase. The most serious problem with granulomatous pancreatic lesion is clinical or radiological misdiagnosis as cancer. We experienced a case of syphilitic granulomatous pancreatitis arising in 54 year old female patient. She was treated for syphilis 20years ago. But she and her husband are still strong positive to VDRL and TPHA. On abdominal computed tomography and endoscopic pancreatico- duodenography, there was an obstructive mass of low density in the distal common bile duct or pancreatic head. Under the preoperative diagnosis of pancreatic head carcinoma, Whipple's operation was done. On gross examination, the pancreas was fibrotic, and the common bile duct was well preserved without tumor mass. Microscopically, numerous intralobular noncaseating epithelioid cell granulomas with multinucleated giant cells are identified. They surround thick-walled, small to medium sized arteries and involve vascular wall with luminal narrowing or obliteration, which are characteristic findings of the syphilitic granuloma. The remaining parenchyme shows fibrosis, acinar atrophy or destruction with dense infiltration of lymphohistiocytes, plasma cells with granuloma formation. Although the Warthin-Starry stain reveals no spirochetes, the serologic result and pathologic findings are compatible with syphilitic granulomatous pancreatitis.
- Interdigitating Reticulum Cell Sarcoma of Lymph Node.
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Sung Suk Paeng, Yoon Ju Kim, Seong Eun Yang, Duck Hwan Kim, Hee Jin Chang, Jung Il Suh, Chu Woo Kim
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Korean J Pathol. 1996;30(7):635-642.
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- We report a case of reticulum cell sarcoma in the right cervical lymph node of a 42-year-old male. It was a slowly growing, non-tender movable mass of 8 months duration.
Microscopically, the lymph node was effaced by proliferating spindle cells arranged in broad sheets, bands, or fascicular patterns in paracortical area sparing of B-cell region. The tumor component was divided by fibrous band. The individual cells had oval to round or elongated nuclei, with inconspicuous nucleoli and moderate amounts of cytoplasms with indistinct cell borders. Pleomorphic large cells with binucleated, or multinucleated bizarre nuclei with prominent nucleoli, were partly admixed. In immunohistochemical stain, the tumor cell was strong positive for S-100 protein, HLA-DR, Mac387 and weakly positive for Leukocyte common antigen and equivocal for Vimentin. But it was negative for CD21, Ki-1, Desmin, Epithelial membrane antigen and Cytokeratin. These immunohistochemical findings suggested that the neoplastic cell was originated from the interdigitating reticulum cell of lymph node. The patient was treated by radiation therapy, and alive well at 37 months of follow-up.
- Fine Needle Aspiration Cytology of Sparganosis.
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Sung Suk Paeng, Yoon Ju Kim, Seong Eun Yang, Hee Jin Chang, Jung Il Suh, Young Chun Moon
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Korean J Cytopathol. 1996;7(1):59-63.
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- Human sparganosis is a rare parasitic disease in which the larval cestode proliferates in the various organs in the body. It usually presents as a subcutaneous or soft- tissue mass. By fine needle aspiration this lesion can be diagnosed with its characteristic cytologic findings.
We experienced 3 cases of sparganosis diagnosed by the fine needle aspiration. Aspirates were taken from subcutaneous mass in the abdomen and both thighs respectively. The aspirates showed a portion of body of sparganum with numerous calcospherules, smooth muscles and tegmentat cells.
They also revealed granulomas with various inflammatory infiltration of eosinophils, neutrophils, lymphocytes and plasma cells.
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