Journal of Pathology and Translational Medicine

Young Hyeh Ko

42 Articles

Fine-Needle Aspiration Cytology of the Nodal Marginal Zone Lymphoma.: Seung Kyu Choi, Ji Eun Kwon, Young Hyeh Ko; Korean J Pathol. 2011;45(4):406-411.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.406

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Abstract PDF: BACKGROUND
Nodal marginal zone lymphoma (NMZL) is a rare B-cell neoplasm consisting of heterogeneous cellular components and residual B-cell follicles. Because of such histological features, it is difficult to diagnose NMZL by fine needle aspiration (FNA) cytology. We reviewed FNA cytology of NMZL to identify a cytological clue to avoid misdiagnosing NMZL.
METHODS
Histological, cytological, and clinical findings of seven cases of NMZL were reviewed.
RESULTS
Most cases showed nodular aggregates of lymphohistiocytes derived from the germinal center irrespective of histological pattern. The cellular components were heterogeneous and composed of mature small lymphocytes, intermediate and large lymphocytes, immunoblasts, tingible body macrophages, and follicular dendritic cells. Intermediate-sized neoplastic cells with a pale nucleus were observed but difficult to identify because of admixed non-neoplastic cells, which outnumbered neoplastic cells. Except for one case with a high proportion of intermediate-sized cells, the other six cases were initially diagnosed as reactive hyperplasia. A flow cytometric analysis was performed in two cases and failed to demonstrate a monoclonal B-cell population.
CONCLUSIONS
The FNA showing a reactive hyperplasia-like smear pattern should be carefully observed by experienced cytopathologists to identify intermediate-sized neoplastic cells. Clinical information including the size of the lymph nodes is important to avoid a misdiagnosis.

WHO Classification of Malignant Lymphomas in Korea: Report of the Third Nationwide Study.: Jin Man Kim, Young Hyeh Ko, Seung Sook Lee, Jooryung Huh, Chang Suk Kang, Chul Woo Kim, Yun Kyung Kang, Jai Hyang Go, Min Kyung Kim, Wan Seop Kim, Yoon Jung Kim, Hyun Jung Kim, Hee Kyung Kim, Jong Hee Nam, Hyung Bae Moon, Chan Kum Park, Tae In Park, Young Ha Oh, Dong Wha Lee, Jong Sil Lee, Juhie Lee, Hyekyung Lee, Sung Chul Lim, Kyu Yun Jang, Hee Kyung Chang, Yoon Kyung Jeon, Hye Ra Jung, Min Sun Cho, Hee Jeong Cha, Suk Jin Choi, Jae Ho Han, Sook Hee Hong, Insun Kim; Korean J Pathol. 2011;45(3):254-260.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.3.254

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BACKGROUND
The aim of study was to determine the relative frequency of malignant lymphoma according to World Health Organization (WHO) classification in Korea.
METHODS
A total of 3,998 cases diagnosed at 31 institutes between 2005 and 2006 were enrolled. Information including age, gender, pathologic diagnosis, site of involvement and immunophenotypes were obtained.
RESULTS
The relative frequency of non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL) was 95.4% and 4.6%, respectively. B-cell lymphomas accounted for 77.6% of all NHL, while T/natural killer (T/NK)-cell lymphomas accounted for 22.4%. The most frequent subtypes of NHL were diffuse large B-cell lymphoma (42.7%), extranodal marginal zone B-cell lymphoma (MZBCL) of mucosa-associated lymphoid tissue (19.0%), NK/T-cell lymphoma (6.3%) and peripheral T-cell lymphoma (PTCL), unspecified (6.3%), in decreasing order. The relative frequency of HL was nodular sclerosis (47.4%), mixed cellularity (30.6%), and nodular lymphocyte predominant (12.1%) subtypes. Compared with a previous study in 1998, increase in gastric MZBCL and nodular sclerosis HL, and slight decrease of follicular lymphoma, PTCL, and NK/T-cell lymphoma were observed.
CONCLUSIONS
Korea had lower rates of HL and follicular lymphoma, and higher rates of extranodal NHL, extranodal MZBCL, and NK/T-cell lymphoma of nasal type compared with Western countries. Changes in the relative frequency of lymphoma subtypes are likely ascribed to refined diagnostic criteria and a change in national health care policy.

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Sanghui Park, Young Hyeh Ko
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Esophageal Gland Duct Adenoma.: Yoonjung Kim, Yang Soon Park, Jei So Bang, Ji Yeon Kim, Young Hyeh Ko, Cheol Keun Park, Kyoung Mee Kim; Korean J Pathol. 2011;45:S45-S47.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.S1.S45

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Abstract PDF: Benign ductal or glandular neoplasms of the esophagus unrelated to Barrett esophagus are extremely rare. Only 9 cases have been reported in the English language literature. We now report a case of esophageal gland duct adenoma incidentally found in a 73-year-old man. A 0.8 cm-sized, polypoid submucosal lesion in the distal esophagus was removed. Histologically, the lesion was well circumscribed and consisted of several ducts or cysts with focal papillary configurations. Interstitial lymphocytic infiltration with germinal centers was also observed. The lining cells of ducts or cysts were composed of two layers: an inner intensely eosinophilic luminal duct cell layer and an outer myoepithelial cell layer that was accentuated by alpha-smooth muscle actin. There was no significant nuclear atypia or mitosis. Mucin production was occasionally observed in a few goblet cells. To the best of our knowledge, this is the first case of benign ductal or glandular neoplasm of the esophagus among Koreans.

Korean Pediatric/Adolescent Lymphoma: Incidence and Pathologic Characteristics.: Seung Sook Lee, Jin Man Kim, Young Hyeh Ko, Jooryung Huh, Chang Suk Kang, Chul Woo Kim, Yun Kyung Kang, Jai Hyang Go, Min Kyung Kim, Wan Seop Kim, Yoon Jung Kim, Hyun Jung Kim, Hee Kyung Kim, Jong Hee Nam, Hyung Bae Moon, Chan Kum Park, Tae In Park, Young Ha Oh, Dong Wha Lee, Jong Sil Lee, Juhie Lee, Hyekyung Lee, Sung Chul Lim, Kyu Yun Jang, Hee Kyung Chang, Yoon Kyung Jeon, Hye Ra Jung, Min Sun Cho, Hee Jeong Cha, Suk Jin Choi, Jae Ho Han, Sook Hee Hong, Insun Kim; Korean J Pathol. 2010;44(2):117-124.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.2.117

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Abstract PDF

BACKGROUND
The Hematopathology Study Group of the Korean Society of Pathologists conducted a nation-wide retrospective analysis of Korean pediatric lymphoma, to provide pathologic data on pediatric/adolescent lymphoma subtypes and features.
METHODS
All lymphoma cases of all age groups were collected during a recent 2 year-period (2005-2006) from 32 institutes in Korea. Among 3,686 lymphoma patients, 142 who were age 18 or less were classified according to the World Health Organization (WHO) classification.
RESULTS
Among 142 pediatric/adolescent lymphoma patients, Hodgkin lymphoma accounted for 21 (14.8%) and non-Hodgkin lymphoma (NHL) for 121 (85.2%). Hodgkin lymphoma appears to be more common in the pediatric/adolescent age group than in the all-ages group (14.8% vs 4.4%). T- and natural killer cell-NHL was more common in the pediatric/adolescent age group than in the all ages group (46.3% vs 22%). The majority of Korean pediatric/adolescent NHL cases was composed of Burkitt lymphoma, T- or B-lymphoblastic lymphoma, anaplastic large-cell lymphoma, and diffuse large B-cell lymphoma. For lymphoma patients under the age of 6 years, most had B-lymphoblastic or Burkitt lymphoma, which commonly presented at extranodal sites.
CONCLUSIONS
The distribution of lymphoma subtypes in the pediatric/adolescent age group is quite different from the distribution of adults, but it was quite similar to distribution in Western countries.

Citations

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A Case of Nasal Type Extranodal NK/T Cell Lymphoma Incidentally Detected in a Child
Ha Jin Oh, Sang Hyun Park, Hae In Jang, Dong Hoon Lee, Yoo Duk Choi, Hee Jo Baek, Hoon Kook
Clinical Pediatric Hematology-Oncology.2015; 22(1): 76. CrossRef

The Prognostic Subgroups as Defined by the Patterns of Epstein-Barr Virus Infection in Patients with Hodgkin Lymphoma.: Ji Hyeon Roh, Seok Jin Kim, Won Seog Kim, Young Hyeh Ko; Korean J Pathol. 2010;44(1):22-27.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.1.22

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Abstract PDF: BACKGROUND
The purpose of this study was to investigate the prognostic significance of the Epstein-Barr virus (EBV) infected non-neoplastic lymphocytes in patients with Hodgkin lymphoma (HL).
METHODS
Seventy-seven cases of HL were evaluated by immunohistochemical analysis and EBV-encoded RNA in situ hybridization. The cases were divided into three groups according to the EBV status. EBV was negative in 48 cases (group 1), EBV was located in the Hodgkin/Reed-Sternberg (HRS) cells, but not in the non-neoplastic lymphocytes in 20 cases (26%) (group 2) and EBV was located in both the HRS cells and the non-neoplastic lymphocytes in 9 cases (12%) (group 3).
RESULTS
The groups differed with respect to the age distribution, the clinical presentation and the prognosis. The median ages were 30 (group 1), 47.5 (group 2) and 23 years (group 3) (p = 0.011). B symptoms (p = 0.007) and the histologic subtype of mixed cellularity classical HL (p = 0.001) were more common in the EBV-positive patients than in their EBV-negative counterparts. Two patients from group 3 had associated chronic EBV infection syndrome. The five-year survival rate was 97.56% in group 1, 75.76% in group 2 and 100% in group 3 (p = 0.0178).
CONCLUSIONS
HL with EBV located in both the HRS cells and the non-neoplastic lymphocytes is a distinct prognostic subgroup that has better survival than the HL with EBV located in only the HRS cells.

A Positive Hybrid (HMW-CK and E-Cadherin) Carcinoma in situ Arising in a Phyllodes Tumor of the Breast: A Case Report.: Yun Kyung Kang, Young Hyeh Ko; Korean J Pathol. 2008;42(2):113-117.

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Abstract PDF: Malignant transformation in phyllodes tumor (PT) is uncommon and almost always confined to the stromal component. Epithelial changes like hyperplasia, metaplasia, and varying degrees of atypia are not uncommon in PT, whereas carcinomatous change is extremely rare. We report a 37-year-old woman with carcinoma in situ (CIS) arising in a benign PT. Grossly, it was a well circumscribed, 4.5 cm-sized mass. The CIS component was confined to the PT and showed overlapping ductal and lobular features with coexpression of E-cadherin and high molecular weight cytokeratin (HMW-CK). The present case emphasizes that careful investigation of multiple microscopic sections is mandatory to find a small carcinomatous lesion within PT. Expression of E-cadherin and HWM-CK in this hybrid CIS suggests that intraepithelial neoplasia of the breast arising in PT may be derived from a common progenitor of the terminal duct-lobular unit.

Quality Assuarance on Fine Needle Aspiration Cytology of Malignant Salivary Gland Neoplasms.: Young Hyeh Ko, Young Lyun Oh; Korean J Cytopathol. 2004;15(1):40-44.

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Abstract PDF: To evaluate the quality of fine needle aspiration cytology diagnosis on malignant salivary gland neoplasms, cytologic findings were correlated with histologic diagnosis of 56 surgically removed malignant salivary gland tumors. Seven cases (12.5%) were insufficient, 23 cases (41.1%) were diagnosed as malignant, 17 (30.4%) cases were accurately diagnosed by histologic subtype, and 9 cases (16%) were diagnosed as benign. Five out of 9 false negative cases were misdiagnosed as pleomorphic adenomas. Except the cases with insufficient specimen, overall sensitivity was 81.6%, and the sensitivity varied according to the histologic subtype; 91% in salivary duct carcinoma, 100% in carcinoma ex pleomorphic adenoma, 50% in mucoepidermoid carcinoma, 63% in adenoid cystic carcinoma, and 50% in acinic cell carcinoma. The diagnostic accuracy differed among cytopathologists irrespective of periods after acquisition of board of pathologists. These results confirm that salivary gland neoplasm can be easily misdiagnosed in fine needle aspiration cytology and a great caution should be given in diagnosing the benign appearing salivary aspirates to avoid under-diagnosis of malignant neoplasm with low grade cytologic atypia.

Disseminated Systemic Candidiasis and Aspergillosis in a Liver Transplant Patient: An Autopsy Report.: Na Rae Kim, Dae Su Kim, Young Hyeh Ko, Sung Joo Kim; Korean J Pathol. 2002;36(5):348-352.

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Abstract PDF: Postoperative complications of liver transplantation include rejection, infection, hepatic vascular thrombus, and primary graft failure, etc. Among them, fungal infection shows nonspecific clinical symptoms and overlapping laboratory findings with variable etiologies causing post-transplant hepatic dysfunction. Therefore, early diagnosis of fungal infection is not easy. Here, we report an autopsy case of disseminated candidiasis and aspergillosis in a liver transplant patient. The case was at first misinterpreted as acute cellular rejection on biopsy because the histology of predominantly cellular infiltration, ductulitis and endothelialitis were similar to those of acute cellular rejection. On autopsy, the liver, lung and kidney showed multifocal hemorrhagic infarcts due to intra-arterial fungal emboli, which were composed mostly of candida species and a minor fraction of aspergillus. Fungal thrombi invading portal vein, intrahepatic arterioles with subsequent coagulation necrosis, venulitis and ductulitis were ascribed to the misdiagnosis on biopsies. It is unusual that systemic candidiasis, unlike aspergillosis, involves large arteries.

Diagnostic Utility of Polymerase Chain Reaction-Based Clonality Analysis for Immunoglobulin Heavy Chain Gene and T-cell Receptor Gamma Chain Gene Rearrangement in Lymphoid Neoplasms.: Eun Yoon Cho, Young Hyeh Ko, Dae Shick Kim, Jae Joon Han, Howe J Ree; Korean J Pathol. 2001;35(6):461-469.

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Abstract: BACKGROUND
The clonality of lymphoid infiltrates determined by polymerase chain reaction (PCR) for immunoglobulin heavy chain (IgH) or T cell receptor (TCR) genes is not only useful in confirming the diagnosis of malignant lymphoma but also in establishing the lineage of a clonal lymphoid proliferation. We analyzed the efficiency of PCR analyses for IgH and TCRgenes that have been routinely applied for the diagnosis of malignant lymphoma in our laboratory.
METHODS
Paraffin sections of 200 cases were analyzed by seminested PCR. Primers were FRIIIA-LJH/VLJH consensus primer for IgH gene and V-J consensus primer for TCR gene. The cases showing negative results by PCR for TCR gene were further analyzed by multiplex V family primers with heteroduplex analysis.
RESULTS
PCR approach for IgH gene allowed detection of clonality in 100% of cases with false positive rate of 0.3% and false negative rate of 0%. The combination of PCR for TCR consensus primers with multiplex V family primers allowed detection of clonality in 91% of cases with false positive rate of 0.6% and false negative rate of 10.3%.
CONCLUSIONS
Combined analysis of IgH and TCR gene rearragnements by the PCR technique followed by heteroduplex analysis can be a useful diagnostic adjunct to determine the clonality of various lymphoproliferative diseases with high sensitivity. But clinical, morphological and immunophenotypical correlation should be considered to reach the final diagnosis due to a few false positive cases.

Primary Nodal Marginal Zone B-cell Lymphoma: Clincopathologic Analysis of Splenic and Mucosa-Associated Lymphoid Tissue Type.: Jae Joon Han, Young Hyeh Ko, Eun Yoon Cho, Mi Kyung Kim, Nam Hun Kim, Howe J Ree; Korean J Pathol. 2001;35(6):470-476.

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Abstract: BACKGROUND
Primary nodal marginal zone B-cell lymphoma (MZBL) is recently divided into mucosa-associated lymphoid tissue (MALT) type and splenic type. Herein, we analyzed clinicopathologic differences of those two types of nodal MZBL.
METHODS
Histologic and clinical findings of eleven cases of primary nodal MZBL lymphoma were reviewed. Immunohistochemical stains for IgD, Ki-67, CD3, and CD20 were performed.
RESULTS
The cases were classified as splenic type in four, MALT type in five, and unclassified in two. The age at presentation was 36.7 years old (range: 16-73) in splenic type and 48 years old (range: 31-68) in MALT type. Two patients with splenic type and one with MALT type had a long history of lymphadenopathy up to 9 years. Whereas tumors of splenic type showed nodular infiltration of tumor cells with follicular colonization and hyperplastic germinal center, tumors of MALT type showed mainly sinusoidal or parafollicular infiltration and atrophic germinal centers. All the patients with splenic type were alive at last follow-up and one patient with MALT type died of disease at 5 months after diagnosis.
CONCLUSIONS
Although the number of cases we analyzed was small, splenic type seems to be distinct from MALT type and lower grade neoplasm.

Genotype of Epstein-Barr Virus and Comparative Genomic Hybridization Analysis of NK/T Cell Lymphoma.: Keying Eun Choi, Young Hyeh Ko; Korean J Pathol. 2000;34(8):541-549.

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Abstract PDF: NK/T cell lymphoma is a distinct clinicopathologic entity which is more prevalent in Asia than in America and Europe and is highly associated with Epstein-Barr virus (EBV) infection. Although the clinicopathologic features of the tumor have been clearly defined, genetic changes and roles of virus associated with the development and progression of tumor have not been well studied. In this study, we carried out polymerase chain reaction (PCR) for EBNA-3B, EBNA-3C, and LMP-1 30 bp deletion to investigate EBV subtype and variants in tumor tissue and performed comparative genomic hybridization (CGH) to screen chromosomal imbalances using frozen tissues from 7 patients with nasal-type NK/T cell lymphoma and 1 patient with blastic NK cell lymphoma. Of 6 cases infected with EBV, there were EBV type 1 in six, LMP-1 30 bp deletion variant in four, and LMP-1 40 bp deletion variant in one. Frequent chromosomal imbalances included deletions at 1p31-pter (4), 12q23-q24 (3), and 17p (4), and gains at 2q (5), 10q (3), and 13q34-qter (4). Blastic NK cell lymphoma displayed deletions of 9q, 7q, and 6q, similar to that of nasal-type NK/T-cell lymphoma. With these results, we assumed that candidate genes in these imbalanced chromosomal loci would provide the clue for further molecular studies to identify putative tumor suppressor genes or proto-oncogenes associated with pathogenesis of this neoplasm.

Fine Needle Aspiration Cytology for Secretory Carcinoma of the Breast in a Female Adult: A Case Report.: Na Rae Kim, Young Hyeh Ko, Young Lyun Oh; Korean J Cytopathol. 2000;11(1):25-30.

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Abstract PDF: Secretory carcinoma of the breast is a rare tumor of the ductal origin with a more favorable prognosis than the conventional ductal carcinoma. To the best of our knowledge, there are a few reports on fine needle aspiration cytology (FNAC) of secretory carcinoma in the English literature and one in the Korean literature. Recently, we experienced a case of secretory carcinoma of the breast performed by FNAC. The cytologic smears revealed several clusters and sheets of cohesive neoplastic cells in eosinophilic secretory background. Individually scattered cells were rarely found. Intracytoplasmic vacuolization and occasional signet ring cells with lacy cytoplasm were detected. To make the diagnosis and differentiation of this rare tumor, an identification of the secretory background and microcystic spaces filled with bluish mucin and occasional nuclear atypism of tumor cells is crucial.

Histopathologic Features and Immunophenotype of 19 Primary Cutaneous Lymphomas.: Hee Sung Kim, Young Hyeh Ko, Howe J Ree; Korean J Pathol. 1999;33(12):1111-1119.

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Abstract PDF: The diagnosis of primary cutaneous lymphoma is based on a combination of clinical, histological, immunophenotypic and genetic criteria. Nineteen cases of primary cutaneous lymphomas were studied for clinicopathologic, immunophenotypic, and genetic features. Seventeen (89%) cases were T cell origin and two cases (11%) were B cell origin. CD30-positive cutaneous lymphoproliferative disorder was the most frequent subtype, occupying 42% (8 cases) of the cases. CD8 was positive in 5 cases consisting of 3 cutaneous T cell lymphomas and 2 anaplastic large cell lymphomas. CD4 was positive in 2 cases of mycosis fungoides and 3 cases of lymphomatoid papulosis. Six (67%) of 9 cases of cutaneous T cell lymphoma were positive for TIA-1. Ten (83%) out of 12 cases showed clonal rearrangements of TCR gamma genes, however, one T/NK cell lymphoma and one anaplastic large cell lymphoma did not. EBV association was detected only in T/NK cell lymphomas among 10 cases examined. In conclusion, our study showed higher proportion of CD30-positive lymphoproliferative disorders and less frequent mycosis fungoides in Korea compared to the incidences in Western countries. Our immunostaining results suggested that mycosis fungoides and lymphomatoid papulosis are CD4-positive T cell origin, however, the remaining primary cutaneous T cell lymphoma is predominantly CD8-positive cytotoxic T cell origin.

Expression of p27kip1, Cyclin D1 and p53 Protein in Ductal Carcinoma In Situ of the Breast.: Young Lyun Oh, Sang Yong Song, Jong Sun Choi, Young Hyeh Ko, Hwoe J Ree, Geung Hwan Ahn; Korean J Pathol. 1999;33(9):709-716.

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Abstract PDF: p27(kip1) protein, a cyclin-dependent kinase inhibitor, has been reported to be a powerful negative prognostic marker in patients with breast carcinoma. However, to this day, studies on p27(kip1) protein expression in ductal carcinoma in situ (DCIS) have been extremely limited. We studied the immunohistochemical expression of p27(kip1) protein in 49 cases of the DCIS and compared the findings to the clinicopathologic parameters, cyclin D1, p53 and estrogen receptor (ER). Positive nuclear staining of p27(kip1) protein was identified in 23 (46.9%) cases. The p27(kip1) protein expression correlated positively with the cyclin D1 immunopositivity (p<0.005) and ER expression (p<0.005). No significant associations were seen in the p27(kip1) protein expression and clinicopathologic parameters. The overexpression of cyclin D1 (59.2% of the cases) correlated positively with ER expression (p<0.001). The p53 protein expression was identified in 30.6% and seemed to be correlated inversely with ER expression (p=0.06). The DCISs with high grade nuclei were more likely to be p53-positive (p<0.05). Our data suggest that the expression of p27(kip1) protein as well as cyclin D1 and p53 protein may be influenced by the ER status in DCIS. The significantly positive correlation of p27(kip1) protein and cyclin D1 expression (p<0.005) supports the theory that the balance of the two opposing signals is important in determining the cell proliferation in breast cancers. Therefore, a comprehensive understanding of loop reaction of p27(kip1)-cyclin D1-ER may be necessary for the treatment of DCIS.

Analyses of Genetic Alterations in Breast Cancers by Comparative Genomic Hybridization.: Jin Man Kim, Young Mi Jeon, Young Hyeh Ko, Kyu Sang Song, Howe J Ree, Joo Seob Keum, Jae Hyuk Lee, Sun Hoe Koo; Korean J Pathol. 1999;33(8):603-613.

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Abstract PDF: Transformation and progression of breast cancer are thought to be caused by an accumulation of complex genetic alterations, but little is known about specific changes. In this study, the author has undertaken a genome-wide screening to detect genetic changes in 20 cases of breast cancer among Koreans, including 16 infiltrating ductal carcinomas, 2 medullary carcinomas, 1 invasive lobular carcinoma, and 1 borderline phyllodes tumor. Comparative genomic hybridization (CGH) was used to screen for DNA sequence gains and losses across all human chromosomes. Simultaneous immunohistochemical staining for c-erbB-2 (Her-2/neu), c-myc, cyclin D1, and p53 protein was done to make comparisons with nuclear grade and that with CGH results. Biotin-labeled tumor DNA and digoxigenin-labeled normal DNA were hybridized to normal metaphase cells. The fluorescence signals were captured by fluorescence microscope after detection by avidin-FITC and anti-digoxigenin rhodamine. Then, the ratio of fluorescence was calculated by an image analyzer. The immunohistochemical staining was done in paraffin-embedded tissue with an LSAB kit and avidin-biotin complex (ABC) method. The CGH results showed gains on chromosomes 8q (40%), 1q (30%), 17q (15%), 20q (15%), 18q (15%), 5p (15%), and 13q (15%). Deletions were on chromosomes 17p (45%) and 22q (20%). High-level amplifications (green/red ratio >1.5) were noted on chromosomes 1p31, 1q, 3q25-qter, 5p, 7q31-qter, 8q, 9p22-qter, 10p, 11p, 11q22-qter, 12p, 12q24, 14q21-qter, 15q23-qter, 17q, 18p, 18q12-qter, 20p, and 20q. By comparison with infiltrating ductal carcinoma, the two medullary carcinomas showed high-level amplification on chromosomes 1p31, 1q, 8q, 10p, 11p and 12p. c-erbB-2, c-myc, cyclin D1, and p53 protein expression was immunohistochemically detected in 9 of 20 (45%), 8 of 20 (40%), 10 of 20 (50%), and 13 of 20 (65%), respectively. The results indicate that the amplification on chromosome 8q, 1q and the deletions on chromosomes 17p and 22q are the most frequent genetic alterations in breast cancers among Koreans. The results reveal a different pattern of genetic alteration from previous studies. The CGH results were not correlated with the immunohistochemical profiles. The amplification pattern of medullary carcinomas was quite different from the pattern of infiltrating ductal carcinomas. The CGH was thought to be very useful in the screening of genetic alterations of solid tumors.

Morphohistometric Investigation and bcl-2 Expression in the Placenta of Chromosomally Abnormal Pregnancy.: Joung ho Han, Kyu Rae Kim, Yeon Lim Suh, Mi Kyung Kim, Young Hyeh Ko, Dae Shick Kim, Howe Jung Ree; Korean J Pathol. 1999;33(5):353-360.

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Abstract PDF: To evaluate the significance of placental histology, a collaborative histological and cytogenetic study was performed on the products of 88 spontaneous abortions, and subsequently bcl-2 immunostaining was performed on 62 cases. The morphometric parameters included were DCIRCLE, FORMSHAPE, CPRATIO, and the expression of bcl-2 immunostainig was graded in four categories (I to IV). The results were as follows: 1) 40% (n=35) were chromosomally abnormal: trisomies predominated (57%, n=20) and was followed by triploidy (14%, n=5), double trisomy (6%, n=2), monosomy X (6%, n=2), inversion (9) (6%, n=2). 2) mean of DCIRCLE in chromosomally abnormal pregnancy was 40 micrometer larger than that in chromosomally normal pregnancy (p=0.012, one side t-test), while no difference was found in FORMSHAPE and CPRATIO between chromosomally abnormal and normal pregnancy. 3) bcl-2 expression was found in syncytiotrophoblast and cytotrophoblast. bcl-2 expression was weaker in chromosomally abnormal pregnancy with intensity I and II of 59% than chromosomally normal pregnancy with intensity I and II of 24%. 4) In comparison bcl-2 expression with DCIRCLE, in chromosomally normal abortion one (10%) in I & II and one (3%) in III & IV showed large DCIRCLE (above 360 micrometer), while 11 (85%) in I & II and 3 (33%) in III & IV in chromosomally abnormal pregnancy. It would mean that bcl-2 protein is necessary in preservation of pregnancy and placental morphology. Abnormal villous diameter and weak bcl-2 expression may be suggestive of chromosomal anomaly. Besides other histologic parameters, application of bcl-2 immunostaining and morphometric analysis probably give more sensitive and specific results in identifying chromosomally abnormal abortion.

A Clinicopathological Study of Posttransplant Liver Biopsy.: Na Rae Kim, Dae Su Kim, Young Lyun Oh, Mi Kyung Kim, Young Hyeh Ko; Korean J Pathol. 1999;33(3):169-178.

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Abstract PDF: Liver biopsies are used routinely in the assessment of graft dysfunction following liver transplantation and generally considered to be the most reliable method for the diagnosis of posttransplant complications with overlapping clinical and laboratory findings. To investigate posttransplant complications causing graft dysfunction and usefulness of liver biopsy, we analysed clinicopathologic features of 65 posttransplant liver biopsies, 2 autopsies and an explanted liver, taken from 20 patients. The frequencies of posttransplant complications were acute cellular rejection in 9 patients (45%), postoperative infection in 11 patients (55%), of which cytomegalovirus (CMV) infection and systemic invasive aspergillosis with candidiasis occured in 10 patients (50%) and 1 patient (5%), respectively. Remainders were hepatic arterial thrombosis in two (10%), primary graft dysfunction due to fatty donor liver in one (5%), and posttransplant lymphoproliferative disorder (PTLD) in two (10%). There were no chronic rejection or recurrent disease. Postoperative mortality was 25%. Histologic grade by Banff schema was well correlated with clinical parameters associated with unfavorable short term prognosis. CMV infection was associated with acute cellular rejection in 6 out of 10 patients (60%). Immunohistochemical staining for CMV was more sensitive method than CMV in situ hybridization or histologic detection of viral inclusion on tissue section. It was unique that one case of PTLD developed under the circumstances of the lowest dosage of immunosuppression and took grave outcome. Based on these results, we concluded that clinicopathologic correlation with integration of all the clinical and laboratory findings is necessary in the interpretation of accurate and early diagnosis of posttransplant liver biopsies. The interrelationship between chronic rejection and CMV infection as well as pathogenetic factors of PTLD remains to be clarified through further ongoing observation.

Diagnostic Usefulness and Limitation of Fine Needle Aspiration Cytology of Lymph Node: Analysis of 176 Cases Confirmed by Biopsy .: Hee Sung Kim, Dae Soo Kim, Young Lyun Oh, Young Hyeh Ko, Howe J Ree; Korean J Cytopathol. 1999;10(1):35-42.

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Abstract PDF: The accuracy of fine needle aspiration cytology(FNAC) of the lymph node was investigated through a review of 176 FNAC cases and the corresponding biopsies. We chose 157 FNAC cases after the exclusion of 19 inadequate ones. Sensitivity of malignancy was 94.0%, specificity 100%, false negativity 6.0%, and false positivity 0.0%. The overall diagnostic accuracy was 96.8%. Sensitivity of metastatic carcinoma was 98.0% and that of malignant lymphoma was 87.9%. False negative cases included one metastatic carcinoma and four malignant lymphomas. The aspirates of metastatic carcinoma with false negativity exhibited a diffuse smear of keratin debris without viable cells, which led to the difficulty in differentiation from benign epithelial cyst. The cases of malignant lymphoma with false negative diagnosis were two Hodgkin diseases, one Lennert's lymphoma, and one peripheral T cell lymphoma in the histologic sections. On the analysis of 39 cases of tuberculosis, 17 cases(43.6%) were diagnosed as tuberculosis, 4(10.3%) as granulomatous lymphadenitis, 3(7.7%) as necrotizing lymphadenitis, and 15(38.5%) as reactive hyperplasia or pyogenic inflammation. Sensitivity of tuberculosis was 53.9%. In conclusion, lymph node FNAC is an excellent non-invasive diagnostic tool for the diagnosis of metastatic carcinoma. The diagnostic accuracy of malignant lymphoma could be improved with flow cytometry or polymerase chain reaction for antigen receptor genes. For the FNAC diagnosis of tuberculosis, AFB stain, culture, and PCR would be helpful as adjuvant techniques.

Significance of the Expression of Cyclin-Dependent Kinase Inhibitor, p27Kip1, in Human Breast Cancer.: Sang Yong Song, Duck Hwan Kim, Yeon Lim Suh, Young Hyeh Ko, Dae Shick Kim, Seok Jin Nam, Jung Hyun Yang; Korean J Pathol. 1998;32(12):1081-1088.

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Abstract: p27Kip1 protein, a negative cell cycle regulator in G1 progression, has been reported to be related with human cancers including colon, breast and non-small cell lung carcinomas. To elucidate a possible prognostic indicator, we studied 49 cases of human breast carcinoma for expression of p27Kip1 protein using an immunohistochemical method, and compared these results with known prognostic parameters of the breast cancer. p27Kip1 protein was intensely stained in nuclei of carcinoma cells in 26 cases (53.1%). The expression rate of p27Kip1 protein was significantly higher in higher nuclear grade (p<0.05), lower histologic grade (p<0.01), lower N classification (p<0.001) and lower clinical stage (p<0.05) than in lower nuclear grade, higher histologic grade, higher N classification and higher clinical stage, respectively. p27Kip1 protein expression was significantly correlated with progesterone receptor status (p<0.05) or cyclin D expression (p<0.05). No statistical correlations were found between expression of p27Kip1 protein and other parameters including tumor size, estrogen receptor status, p53 overexpression and c-erbB-2 expression. The results suggest that reduced expression of p27Kip1 protein plays a role in biologically aggressive behavior of breast carcinoma and might contribute in predicting breast cancer patient's survival.

Primary Central Nervous System Lymphomas; A Clinicopathologic Study of 18 Cases.: Yu Kyung Jeong, Young Hyeh Ko, Dong Kyu Na, Yeon Lim Suh, Sang Yong Song, Dae Shik Kim, Mi Kyung Kim, Howe Jung Ree; Korean J Pathol. 1998;32(9):670-679.

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Abstract: The incidence of a primary central nervous system (CNS) lymphoma in western countries is about 1% of all the intracranial tumors and has increased 2.2% over the last decade. A similar pattern of increased frequency is observed in Korea. Although most CNS lymphomas in western countries are high grade tumors carrying poor prognosis, the clinicopathologic features of the Korean CNS lymphoma have not been well studied. We report clinicopathological features of 18 cases of histologically proven primary brain lymphoma. The mean age of the patients was 50 years and there was no sex difference. The clinical and radiological characteristics included multiple site of occurrence, infrequent extracranial spread, and frequent seeding via cerebrospinal fluid. No patients were immune-compromised host. Of 18 cases, 15 cases were of B-lineage and 2 cases were of T-lineage. According to REAL classification, there were 12 cases of diffuse large B cell lymphoma, two cases of B cell lymphomas of small lymphoid cell, and two cases of peripheral T cell lymphoma, unspecified. The remaining subtypes were not subclassified because of inadequate material. Pleomorphic cytologic features and necrosis of varying extent were frequent in the cases of diffuse large B-cell lymphoma. These results suggest that overall clinicopathologic features of primary malignant lymphomas of the central nervous system in Korea are similar to those of western countries.

Primitive Neuroectodermal Tumor of the Kidney: A case report .: Sang Yong Song, Eun Youn Cho, Jung Won Lee, Jai Hyang Go, Mi Kyung Kim, Dae Shick Kim, Young Hyeh Ko; Korean J Pathol. 1998;32(3):231-236.

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Abstract PDF: Peripheral primitive neuroectodermal tumor (pPNET), a rare, highly aggressive neoplasm of indetermined histogenesis, occurs typically in the soft tissues of the chest wall and the paraspinal region. Comprehensive diagnostic studies including histological, ultrastructural, immunohistochemical and molecular analyses have been stressed to diagnose this entity. We report a case of primary renal PNET which was incidentally found in a 59-year-old man who presented with generalized weakness for 4 months. He was diagnosed as a non-insulin dependent diabetes mellitus 15 years ago and has been made well by oral therapy. An ill-defined mass, measuring 3.5 3 cm, located in the left kidney and perirenal fat, was incidentally found by ultrasonogram during a renal diabetic examination. The mass was resected because of the unresponsiveness against one-year chemotherapy and radiation therapy. Grossly, a homogeneously solid, gray-white mass, measuring 2.8 1.8 cm, was noted in the mid portion of renal cortex. The mass showed severe adhesion to the perirenal fatty tissue. Microscopically, tumor cells were rather uniform, small round with scanty cytoplasm and often showed rosette formation. Ultrastructurally, they showed membrane-bound dense core granules, measuring 125~150 nm, intercellular junctions and microvillous cytoplasmic projections. The tumor cells were uniformly immunoreactive for neuron-specific enolase and were focally immunoreactive for CD99 (013), chromogranin, synaptophysin and cytokeratin. They were not reactive for S-100 protein, vimentin, Leu-7, leukocyte common antigen, desmin and smooth muscle actin. To our knowledge, this is the smallest renal PNET in literature.

Alveolar Soft Part Sarcoma of the Lung Diagnosed by Fine Needle Aspiration Cytology: A Case Report .: Dae Su Kim, Young Lyun Oh, Young Hyeh Ko; Korean J Cytopathol. 1998;9(2):187-192.

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Abstract PDF: Alveolar soft part sarcoma(ASPS) is a rare malignant neoplasm with a distinct clinicopathologic entity of which fine needle aspiration(FNA) cytologic findings have been described in only a few reports. Although patients usually present with an isolated soft-tissue mass in the extremity, metastasis can occur in about 13 % of total cases and the most frequent metastatic site is the lung. We have recently experienced a FNA cytologic case of ASPS in the lung. A 23-year-old female patient was admitted to this hospital due to 2-month-history of cough. She had been good in health before the visit. Chest computed tomography revealed multiple, variable sized, bilateral pulmonary nodules. Physical examination and other staging work up revealed no other lesions except for pulmonary nodules. A percutaneous transthoracic FNA was performed from the pulmonary nodules. The smear was cellular and most cells were arranged singly. In addition, a few clusters lined by thin-walled vasculature with a pseudoalveolar pattern were present. Some of the tumor cells were large and polygonal to oval with abundant granular or vacuolated cytoplasm. Most cells were naked nuclei showing finely granular chromatin pattern with prominent central nucleoli.

Fine Needle Aspiration Cytology of Anaplastic Large Cell Lymphoma: A case mimicking malignant fibrous histiocytoma.: Jung Won Lee, Young Lyun Oh, Young Hyeh Ko; Korean J Cytopathol. 1998;9(1):99-104.

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Abstract PDF: Anaplastic large cell lymphoma(ALCL) is an uncommon type of non-Hodgkin's lymphoma(NHL) populated with anaplastic, often bizarre cells that express CD30 (Ki-1) antigen. The unusual histologic and cytologic features may cause confusion with other neoplasms, such as poorly differentiated carcinoma, melanoma, Hodgkin's disease, or true histiocytic lymphoma. Although the cytologic features of ALCL have been well described, there are few reports about cytologic findings of the sarcomatoid variant of ALCL. We experienced a case of fine needle aspiration(FNA) cytologic findings of ALCL which mimicks malignant fibrous histiocytoma. FNA cytology of chest wall mass in a 62-year-old female with a history of peripheral T-cell lymphoma(Lennert lymphoma) revealed a heterogeneous population of single cells and poorly cohesive cells with large, pleomorphic nuclei and spindle cells gathering around vascular structures within an inflammatory background. Additional features of the neoplastic cells were eccentric, multilobated nuclei with occasional "wreath-like" configuration; abundant cytoplasm with vacuolization; and prominent nucleoli. The cytologic features suggested sarcoma, especially malignant fibrous histiocytoma. The diagnosis was made retrospectively with an aid of immunocytochemical staining.

Fine Needle Aspiration Cytology of Metastatic Melanoma in the Breast: A Case Report.: Young Lyun Oh, Young Hyeh Ko; Korean J Cytopathol. 1998;9(1):111-116.

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Abstract PDF: Although the characteristic cytologic features of melanoma have been well described, the diagnosis of metastatic melanoma by fine needle aspiration cytology (FNAC) may be difficult in the case of amelanotic melanoma and in the absence of awareness of clinical history. Furthermore, when the breast is the site of initial presentation, it could simulate a primary breast carcinoma leading to misdiagnosis. The recognition of metastatic malignant melanoma in FNAC material is essential to avoid an unnecessary mastectomy and to ensure appropriate chemotherapy. We experienced a case of metastatic melanoma of breast which presented as solitary breast mass in a 56-year-old woman. She had a history of surgical excision of right foot for melanoma one year ago. The cytologic smears were composed of noncohesive epithelioid cells with round or eccentric nuclei, bi-or multi-nucleation, prominent nucleoli, fine chromatin, and intranuclear inclusions. The cytoplasm of tumor cells had scanty melanin pigment but were diffusely positive for S-100 protein.

Correlation between p53 Immunohistochemical Expression, DNA Ploidy and Ki-67 Expression in Gastric Carcinoma.: Young Lyun Oh, Joung Ho Han, Young Hyeh Ko, Cheol Keun Park, Hwoe J Ree; Korean J Pathol. 1997;31(12):1264-1271.

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Abstract PDF: We examined the p53 protein overexpression and evaluated its correlation with pathobiological variables, including: (1) patient age, sex, tumor size, histological type and grade, invasion depth, vascular invasion, perineural invasion and lymph node status; (2) the Ki-67 labeling index in 100 gastric carcinomas; and (3) the DNA ploidy pattern, S phase fraction (SPF), and the proliferation index (PI) in 84 cases using flow cytometry. The positive rate of p53 staining was 48% and the p53 immunoreactivity was independent of variable clinicopathologic factors. No correlation was made between the Ki-67 labeling index with p53 immunostaining and DNA ploidy parameters. Aneuploidy rate was slightly higher in the p53 positive group (55.6%) than the p53 negative group (44.4%)(p=0.097). The mean values of SPF and PI were significantly higher in the p53 protein positive group. Aneuploidy was more often observed in the intestinal type (p=0.038), advanced gastric carcinoma (p=0.015) and lymph node positive group(p=0.039). The above results suggest that although the p53 protein overexpression has no significant correlation with pathological factors and the Ki-67 labeling index, it may play an important role in tumor cell proliferation. Since p53 protein overexpression was slightly higher in the aneuploidy group showing significant correlation with poor prognostic parameters, it is thought that re-evaluation of the p53 mutation by molecular biological study is needed.

Expressions of Epidermal Growth Factor Receptor, c-erbB-2 and p53 Protein as Useful Markers of Malignant Potential in a Transitional Cell Carcinoma of the Urinary Bladder.: Gu Kong, Ki Yong Shin, Sun Jin Kim, Young Hyeh Ko, Hae Young Park, Young Nam Woo, Jung Dal Lee; Korean J Pathol. 1997;31(1):51-58.

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Abstract PDF: Transitional cell carcinoma(TCC) of the urinary bladder shows marked heterogeneity in biological behaviors. Evidence has accumulated that biological markers may provide significant information to predict the potential aggressiveness of TCC. We have assessed the expression of the epidermal growth factor receptor (EGF-R), c-erbB-2 and p53 proteins in 56 cases of TCC to investigate the prognostic significance of differential expression of these oncoproteins using an immunohistochemical method. We analysed the expression patterns of these oncoproteins according to tumor stage and grade. And we assessed the probability of progression-free survival in stage T1 tumors according to their expressions. Positive rates of EGF-R (>+3 staining intensity), c-erbB-2 (intense membrane staining) and p53 proteins (>20% positive cells) were 73.2%, 37.5% and 42.9%, respectively. Invasive tumors had significantly higher positive rates of all three factors than did superficial tumors (p<0.005 for EGF-R and c-erbB-2, p<0.05 for p53). High grade tumors had significantly higher positive rates of c-erbB-2 and p53 proteins (p<0.005). In superficial tumors, T1 tumors had higher positive rate of p53 protein compared with Ta tumors (p<0.05). Twelve cases of superficial tumors (34.3%) were positive for EGF-R and negative for c-erbB-2 and p53 proteins. Nine cases of superficial tumors(25.7%) were negative for all three factors. In invasive tumors, however, 42.5% of the cases were positive for all three factors. The overexpression of p53 protein was the only useful marker to predict the rapid progression in stage T1 tumors (p<0.05, log-rank test). These results suggest that the differential overexpression of EGF-R, c-erbB-2 and p53 proteins could be useful to depict tumor aggressiveness of TCC of the urinary bladder. And, the overexpression of a p53 protein may be a useful marker to predict the possibility of rapid progression in stage T1 tumors.

Leydig Cell Tumor of the Ovary: Report of a case.: Jin Haeng Chung, Kyu Rae Kim, Young Hyeh Ko; Korean J Pathol. 1996;30(11):1050-1052.

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Abstract PDF: Leydig cell tumor of the ovary is a very rare tumor which usually occurs in the postmenopausal age, and which is frequently associated with virilization. It has been classified as a lipid cell tumor due to the presence of intracytoplasmic lipids. However, since up to 25% of these tumors contain little or no lipid, the new term "steroid cell tumor" is proposed for this type of neoplasm. We report a case of Leydig cell tumor of the ovary in a 16 year old girl. The patient exhibited recently recognized hirsuitism and secondary amenorrhea. Physical examination revealed moderate obesity with moderate amounts of coarse hair over the whole body and a deepening of the voice. Testosterone and dehydroepiandrosterone sulfate levels were markedly elevated in the peripheral blood. Pelvic ultrasonography revealed a right ovarian tumor. The resected ovary showed a well demarcated, golden yellow to orange colored solid mass, measuring 7 cm on the cut surface. Microscopically, the tumor was composed of solid and diffuse sheets of tumor cells having abundant eosinophilic cytoplasm, and large round nuclei with frequent crystalloids of Reinke in the cytoplasm. To our knowledge this is the first case of Leydig cell tumor of the ovary in a young girl in the Korean literature.

Epstein-Barr Virus in Korean Malignant Lymphomas.: Young Hyeh Ko, Jung Dal Lee; Korean J Pathol. 1996;30(11):1011-1017.

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Abstract PDF: To determine the prevalence of Epstein-Barr virus infection in lymphoid neoplasms of various histology and location, the paraffin tissues of 74 non-Hodgkin's lymphomas and 13 Hodgkin's diseases were studied by EBER and BHLF RNA in situ hybridization as well as immunostaining using LMP-1, EBNA-2, and ZEBRA. As a control, non-neoplastic lymphoid tissues from the nasal cavity(10), lymph node(38) and Waldeyer's ring(12) were investigated. In non-neoplastic control, EBV genome was detected in none of 10 nasal mucosa, 6 of 38 lymph node, and 1 of 12 Waldeyer's ring. EBV-positive non-neoplastic lymphocytes expressed CD45RO in 2 cases and CD20 in 4 cases. Non-Hodgkin's lymphoma was positive for EBV in 37.8% of the cases in which T-cell lymphoma showed higher rate(56%) than B-cell lymphoma(15%), especially in nasal lymphoma(80%) and angiocentric lymphoma(63.6%). Hodgkin's disease was EBV positive in 38.4% of the cases. EBV genome in tumor tissue existed in latent form as well as in lytic form. LMP-1 was positive in 80% of Hodgkin's disease and 39% of non-Hodgkin's lymphoma in which EBV genome was detected. EBNA-2 was expressed in 3 cases of non-Hodgkin's lymphoma. On the basis of protein expression, most lymphomas belonged to type II latency. These results support that EBV is associated with pathogenesis of malignant lymphoma although its mechanism still awaits to be clarified.

Invasive Extramammary Paget Disease: A Report of 2 Cases with Immunohistochemical and Ultrastructural Findings.: Kyu Rae Kim, Chong Woo You, Jeong Ho Han, Young Hyeh Ko; Korean J Pathol. 1996;30(9):858-864.

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Abstract PDF: We present 2 cases of invasive extramammary Paget disease occuring in the vulva area of a 60 year old female, and in the scrotal and penile area of a 63 year old male patient. The histologically typical Paget cells were not only seen in the surface epithelium but were also involved in the outer root sheath of the hair follicles. Stromal infiltration of tumor cells into the upper dermis were present in both cases, however, no underlying primary sweat gland carcinoma was present. Metastatic foci of inguinal lymph nodes showed apocrine-type epithelium with abundant eosinophilic granular cytoplasm, which were positive for anti-CEA and GCDFP-15, as well as eccrine-type epithelium containing mucinous secretory materials in the lumen and the cytoplasm. Ultrastructural findings showed interdigitating plasma membranes with prominent desmosomes between the Paget cells, intracytoplasmic tonofibrils, intracellular tubules, lipid vacuoles, and enlarged mitochondria. Histological, immunohistochemical, and ultrastructural findings suggested that Paget cells showed both eccrine and apocrine differentiation.

Intraductal Papillary-Mucinous Neoplasm of the Pancreas: A case report.: Ji Eun Kim, Young Hyeh Ko, Howe Jung Ree, Yong Il Kim, Poong Ryul Lee; Korean J Pathol. 1996;30(8):726-732.

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Abstract PDF: Intraductal papillary mucinous neoplasm (IPMN) is a recently recognized clinicopathologic entity characterized by dilatation of pancreatic duct filled with copious mucin and papillary ductal epithelial proliferation ranging from simple hyperplasia to invasive carcinoma. The exact clinicopathologic identification of this tumor is important because of favorable prognosis contrast to that of conventional ductal adenocarcinoma. Herein we report a case of surgically resected typical IPMN. A 59-year-old man had a long history of diabetes mellitus with epigastric pain of 4 months duration. Ultrasonography and computed tomographic examination revealed cystic dilatations of main pancreatic duct in the head. The patient underwent total pancreatectomy. The gross appearance showed diffuse dilatation of main pancreatic duct associated with cystic dilatation of subbranches in the uncinate process. Histologic examination revealed diffuse papillary proliferations lined by mucinous epithelium with mild atypism within ectatic ducts. No invasive carcinoma was noted. Histochemically, the papillary epithelium contained mostly neutral and acid sialomucin.

Fibrous Pseudotumor of the Testicular Tunics: Two case reports.: Seung Sam Paik, Nam Hoon Kim, Young Hyeh Ko, Moon Hyang Park; Korean J Pathol. 1995;29(4):533-535.

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Abstract PDF: Fibrous pseudotumor of the testicular tunics is a rare benign fibrous proliferative disorder, but it is the second most common mass-forining lesion of the testicular tunics. While these lesions are not strict neoplasms, they do form nodules and are often mistaken for neoplasms. Herein, we report 2 cases of fibrous pseudotumor with characteristic histologic findings. Both cases had been incidentally found as slow growing scrotal masses and underwent excision. There were several nodules along the testicular tunics which had bulging whitish-gray cut surface with focal myxoid change and a whorling appearance. These two cases showed the histologic spectrum seen in fibrous pseudotumor from a haphazard arrangement of fibroblastic type cells with intervening collagen and focal lymphocytic infiltrates in case 1, to a densely collagenized lesion in case 2.

Non-Hodgkin's Lymphoma of the Uterine Cervix: 3 cases report.: Chan Pil Park, Young Hyeh Ko, Jung Dal Lee, Moon Il Park, Kyung Tai Kim, Sam Hyun Cho; Korean J Pathol. 1995;29(3):368-373.

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Abstract PDF: Three patients with primary non-Hodgkin's lymphoma of the uterine cervix are reported and the literature is reviewed. All the three patients in the current study presented with vaginal bleeding. They were found to have diffuse large cleaved cell lymphoma, one of which was multilobated variant with marked sclerosis. Histologically, differential diagnsis from undifferentiated small cell carcinoma, endometrial stromal sarcoma & other sarcomas was difficult and requires special stains including immunobistochemical study. Vaginal pap smears were diagnosed as 'class V; malignant lymphoma' in only one patient. Immunologically, two cases were beta-cell lineage and one case was T-cell lineage. All the patients were treated with chemotherapy only and showed good responses.

A Case of Malignant Lymphoma Misdiagnosed as Focal Lymphoid Hyperplasia in the Esophagus.: Sook Keum Chung, Young Hyeh Ko, Chan Keum Park, Jung Dal Lee; Korean J Pathol. 1995;29(3):393-398.

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Abstract PDF: Esophageal involvement by malignant lymphoma is extremely rare. A case of follicular lymphoma of the esophagus, misdiagnosed as focal lymphoid hyperplasia (pseudolymphoma) in a 72-year-old man is presented. The esophagogram revealed diffuse narrowing of the lumen in the middle and distal portion without ulceration. The resected esophagus showed mural thickening without any remarkable mucosal change. Microscopically, the esophagus showed scattered follicular lymphoid aggregates in the submucosa, extending into periadventitial fat tissue. Most follicles were devoid of germinal center and consisted of loosely aggregated small cleaved cells without atypia. The surrounding stroma of the submucosa showed dense fibrosis entrapping the infiltrating small lymphocytes in a "indian-file" appearance. There were some reactive follicles with germinal center. In the lamina propria, many plasma cells and a few eosinophils were infiltrated. The gene rearrangement study showed rearranged band for Jk probe which confirmed monoclonal B-cell nature of infiltrated small lymphoid cells. The small cleaved lymphocytes arranged in follicles were positive for L26 and bcl-2 protein. This case demonstrated the necessity of immunophenotypic and gene rearrangement study in the diagnosis of pseudolymphoma in the digestive tract.

Cytologic Features of Malignant Lymphoma of the Uterine Cervix: A case report.: Nam Hoon Kim, Chan Kum Park, Young Hyeh Ko, Moon Hyang Park, Jung Dal Lee; Korean J Cytopathol. 1995;6(1):76-79.

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Abstract PDF: The uterine cervix is an uncommon site of primary non-Hodgkin's lymphoma (NHL). Although the cytologic findings of NHLs are well known, most cervicovaginal smear of uterine NHLs give lower diagnostic yield than common epithelial malignancy because abnormal cells do not appear in the sample in the absence of surface ulceration. Herein, we describe cytologic findings of a case of uterine cervical NHL which was initially diagnosed by cervicovaginal smear. The tumor cells were relatively uniform, isolated, large-sized with scanty cytoplasm and round or indented nuclei. The nuclei had stippled chromatin and small nucleoli. Histologically and immunohistochemically the tumor was proven to be large cell lymphoma of T-cell lineage.

Glycogen-Rich Clear Cell Carcinoma of Breast: A case report.: Nam Hoon Kim, Wan Seop Kim, Young Hyeh Ko, Jung Dal Lee; Korean J Pathol. 1994;28(3):316-318.

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Abstract: Glycogen-rich clear cell carcinoma of the breast is very rare(l -3% of breast cancer). It is defined as a tumor composed of more than 50% of optically clear, neoplastic cells, characterized by centrally located nuclei and abundant cytoplasm, being positive for periodic acid Schiff(PAS) and negative for periodic acid Schiff after diastase(D-PAS) treatment. In the absence of intraductal or in situ lobular carcinoma component, metastatic clear cell carcinomas of other organs should be considered as diagnostic possibilities. We report a case of glycogen-rich clear cell carcinoma arisen in a 62-year-old woman. The tumor revealed both solid and papillary pattern with intraductal component. The neoplastic cells had clear cytoplasm, which were PAS positive, D-PAS negative, mucicarmine negative and oil red 0 negative. More than 90% of tumor cells exhibited moderate staining for anti-estrogen receptor monoclonal antibody. Flow cytometric DNA analysis revealed diploid DNA content.

Immunohistochemical Study of Upper Respiratory Tract Malignant Lymphomas with Features of Polymorphic Reticulosis.: Jeong Ja Park, Tae In Park, Young Hyeh Ko, Jung Dal Lee; Korean J Pathol. 1994;28(2):144-148.

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Abstract PDF: Malignant lymphomas of the upper respiratory tract are relatively common in the Orient including Korea. They have a marked clinicopathologic and immunophenotypic diversity. We retrospectively reviewed 20 cases of malignant lymphomas with features of polymorphic reticulosis in the upper respiratory tract. Histopathologic findings consisted of polymorphism of lymphoid cells in 17 cases(85%), angiocentricity in 14 cases(70%), coagulation necrosis in 12 cases(60%), and epitheliotropism in 8 cases(40%). By Working Formulation, 14 cases(70%) were classified as diffuse large cell type, 4 cases(20%) as diffuse mixed small cleaved and large cell type, one case as immunoblastic type, and one case as anaplastic large cell type. On immunostaining, one showed B-cell phenotype and 19 cases showed T-cell phenotype. The B-cell type was histologically diffuse large cell type. From these results, we concluded that polymorphic reticulosis is a type of peripheral T-cell lymphoma with angiocentricity.

Immunohistochemical Study for Ki-1 and EMA Antigens in Large Cell Lymphoma including Anaplastic Large Cell Lymphoma.: Soon Ae Oak, Young Hyeh Ko, Jung Dal Lee; Korean J Pathol. 1994;28(2):135-143.

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Abstract PDF: To evaluate the frequency of EM A and Ki-I antigen expression in the large cell lymphoma and to define the histologic characteristics of Ki-1 positive anaplastic large cell lymphoma, 40 cases of malignant lymphoma, diffuse large cell type were immunostained by Ki-I and EMA monoclonal antibodies. Eight cases of large cell lymphomas expressed EMA, among which 4 cases were positive for Ki-I antibody as well. The positive rate for EMA was much higher in T cell lymphomas than in B cell lymphomas. Among 4 cases of Ki-I positive lymphomas, 2 cases showing membrane staining of Ki-1 with prototypic histologic feature of anaplastic large cell lymphoma were classified as Ki-1 positive anaplastic large cell lymphoma(ALCL). Ki-I positive ALCL were T-cell in one and non-T, non-B cell type in the other, respectively. The remaining 2 cases of Ki-1 positive lymphomas showing cytoplasmic staining were classified as both B-cell centroblastic/centrocytic lymphoma and T-cell pleomorphic large cell lymphoma.

Retroperitoneal Mucinous Tumor: Report of two Cases.: Eun Kyung Kim, Seong Ran Hong, Hy Sook Kim, Young Hyeh Ko, Jung Dal Lee; Korean J Pathol. 1992;26(6):632-634.

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Abstract PDF: Primary retroperitoneal mucinous tumor is very rare. In the worldwide literature, only 14 cases have been reported. Herein, we report two cases of retroperitoneal mucinous tumor found at laparotomy. The patients were females, aged 24 and 21 years, respectively. They had bilateral normal ovaries. Histologically, one was mucinous cystadenoma and the other showed borderline histology. The connective tissue wall resembling ovarian stroma was noted in one case. The pathogenesis was discussed.

Cytologic features of Langerhan's cell histiocytosis.: Geun Shin Lyu, Young Hyeh Ko, Moon Hyang Park, Jung Dal Lee; Korean J Cytopathol. 1991;2(2):153-159.

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Abstract PDF: No abstract available.

Cytologic findings of Hodgkin's disease with special emphasis on Reed-Sternberg cells and their variants.: Young Hyeh Ko, Chan Pil Park, Jung Dal Lee; Korean J Cytopathol. 1991;2(1):1-7.

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Abstract PDF: Cytologic findings from five cases with variable types of Hodgkin' disease were reviewed with special emphasis on the Reed-Sternberg (R-S) cells and their variants. Typical R-S and Hodgkin's cells were mono- or binucleated, and nuclei had rounded smooth contour. Acidophilic prominent nucleoli with perinucleolar halo were conspicuous. In comparison to typical Reed-Sternberg cells, L & H (lymphocytic and histiocytic) cells in the lymphocyte predominant type tended to show pop-corn like irregular nuclear contour and to lack the prominent nucleoli. Lacunar cells in the nodular sclerosis type had multilobated nuclei with prominent acidophilic nucleoli. There was no prominent perinucleolar halo in L & H and lacunar cells. In conjuction with the number of Reed-Sternberg cells and back ground findings observed on the smears, the characteristic features of R-S cells and their variants allowed to make typing of Hodgkin's disease.

Ki-1 Positive T-Cell Lymphoma of Bone in a Child.: Hye Seon Ahn, Gil Ro Han, Jin Hee Sohn, Jung Il Suh, Young Hyeh Ko; Korean J Pathol. 1989;23(4):470-475.

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Abstract PDF: Ki-1 monoclonal antibody is a well known marker for Reed-Sternberg cells in Hodgkin's disease, but also occasionally reacts with activated lymphoid cells of either benign or malignant nature. Recently, Ki-1 antibody positive Non-Hodgkin's lymphoma, usually of large cell and/or polymorphous type, has been reported in the lymph nodes, skin, soft tissue, and stomach, but not in the bone. We report a case of multifocal primary bone lymphoma in a seven-year old body involving the left shoulder and right frontal bone, which proved to be a large cell, polymorphous lymphoma, helper T-cell type expressing Ki-1 antigen.

Fetus-in-fetu: Report of a case.: Young Hyeh Ko, Moon Hyang Park, Doo Pyo Hong, Poong Man Jung; Korean J Cytopathol. 1985;19(2):223-225.

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Abstract PDF: A case of Fetus-in-fetu is reported. The patient was a 8 month-old-boy with a tumor in the left upper retroperitoneum. The characteristic feature of the specimen consisted of vertebral column including pelvis, both upper and lower extremities, neural canal and brain tissue, and well formed large intestine.

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