Journal of Pathology and Translational Medicine

Jae Y Ro

37 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

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

Solitary Fibrous Tumor of the Kidney: A Report of Two Cases with Review of Literature.: Sun A Kim, Jung Eun Hwang, Jae Y Ro, Kyung Ja Cho, Cheryn Song, Mi Jung Kim; Korean J Pathol. 2010;44(4):420-425.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.4.420

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Abstract PDF

Solitary fibrous tumor (SFT) is a benign mesenchymal neoplasm usually occurring in the pleura. Kidney is one of the rarest sites for SFT. We report here on two cases of renal SFT found in 30-year-old and 33-year-old men with review of the literatures. Both cases manifested as well-enhanced solid masses in kidney and radical nephrectomies were done. The tumors consisted of bland-looking spindle cells arranged in short, ill-defined fascicles and storiform pattern with characteristic hemangiopericytoma-like blood vessels. The tumor cells were strongly positive for CD34 and CD99, focally positive for bcl-2, and negative for cytokeratin and human melanoma black-45 on immunohistochemical stainings. Possibility of SFT should be considered in the differential diagnosis of a renal mass which consists of benign-looking spindle cells and hemangiopericytomatous blood vessels. Immunohistochemical staining for CD34 is essential to confirm the renal solitary fibrous tumor.

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Solitary fibrous tumor located in the sella turcica: A report of two cases and review of the literature
XIAO YANG, QINGJUN JIANG, BINGBING YU
Oncology Letters.2015; 10(1): 354. CrossRef
Pediatric Renal Solitary Fibrous Tumor
William W. Wu, Julia T. Chu, Stephen G. Romansky, Lisa Shane
International Journal of Surgical Pathology.2015; 23(1): 34. CrossRef

Mycophenolate Mofetil-Related Colitis: A Case Report.: Kyungeun Kim, Jerad M Gardner, Mary Schwartz, Matthew L Tompson, Jae Y Ro; Korean J Pathol. 2010;44(3):333-337.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.3.333

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Abstract PDF

Mycophenolate mofetil (MMF)-related colitis is one of the common causes of afebrile diarrhea in transplant patients. Pathologic diagnosis of MMF-related colitis is difficult because microscopic findings of MMF effects resemble those of graft-versus-host disease, inflammatory bowel disease and ischemic colitis. However, if diagnosed, MMF-induced colitis can be markedly improved by discontinuing the drug. A 70-year-old man having a history of transplantation presented with a one month history of afebrile diarrhea. Colonoscopy revealed patchy erosions. The colonoscopic biopsy specimen showed not only crypt disarray with degenerated crypts and scattered epithelial cell apoptosis, but also stromal inflammatory cell infiltration. A review of his medical records showed that he had been taking immunosuppressive drugs including MMF since his heart transplantation 6 years prior. The histologic findings of colonic mucosa were consistent with MMF-related colitis. After discontinuing MMF, the diarrhea quickly resolved and has not recurred for 10 months.

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Colitis eosinofílica inducida por micofenolato: reporte de caso
Mario Alberto Caviedes-Cleves, Ariel Antonio Arteta-Cueto
Iatreia.2023;[Epub] CrossRef
Mycophenolate Mofetil-Induced Colonic Injury Manifesting Endoscopically As Ischemic Colitis
Clive J Miranda, Murad H Ali, Muddasir Ayaz, Raheel M Khan, Mayada Ismail
Cureus.2023;[Epub] CrossRef
Transformation of the Amino Acid Pool in the Rat Brain under Conditions of Experimental Immunodeficiency
N. I. Filina, M. N. Kurbat
Neurochemical Journal.2022; 16(2): 174. CrossRef
A Case Series of De Novo Inflammatory Bowel Disease After Kidney Transplantation
P. Azevedo, C. Freitas, P. Aguiar, H. Silva, T. Santos, P. Farrajota, M. Almeida, S. Pedroso, L.S. Martins, L. Dias, R. Vizcaíno, A. Castro Henriques, A. Cabrita
Transplantation Proceedings.2013; 45(3): 1084. CrossRef

Histological and Immunohistochemical Findings of the Intermediate Trophoblasts in Normal Full Term and Pre-eclamptic Placentas.: Sang Hak Han, Kyu Rae Kim, Yonghee Lee, Jae Y Ro; Korean J Pathol. 2010;44(1):63-69.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.1.63

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Abstract PDF: BACKGROUND
Recent studies have suggested that implantation site intermediate trophoblasts (ISITs) and chorionic type intermediate trophoblasts (CTITs) show different immunohistochemical findings, and that each type has specific location in placentas. However, we observed that both subtypes are intimately admixed in many areas of the placentas and both types are proliferated around the infarcts.
METHODS
In order to examine the site specificity in their distribution and the changes of intermediate trophoblasts (ITs), if any, in the pre-eclamptic placentas, quantitative analyses of ISITs and CTITs using p63, CD146, placental alkaline phosphatase, human placental lactogen, and alpha-inhibin were performed in normal and pre-eclamptic placentas containing infarcts.
RESULTS
In the fetal membranes of both normal and pre-eclamptic placentas, CTITs and ISITs were equally identified, forming distinct layers. ISITs were predominant in the intervillous septum and basal plate, while CTITs were predominant in the subchorionic area. At the margin of infarcts in pre-eclamptic placentas, both subtypes were increased in number, forming distinct layers.
CONCLUSIONS
The subtypes of ITs do not have site specificity in placentas. Increased number of ITs and zonal distribution around infarcts suggest that CTITs and ISITs have differentiation associated relationship, and the differentiation might be related to the microenvironment of placenta, such as intraplacental oxygen concentration.

Immunohistochemical Markers for Metastasis in Clear Cell Renal Cell Carcinoma.: Kyungeun Kim, Cheryn Song, Jae Y Ro, Hanjong Ahn, Yong Mee Cho; Korean J Pathol. 2008;42(2):81-86.

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Abstract PDF: BACKGROUND
Renal cell carcinoma (RCC) is notorious for its high metastatic potential, and 30% of RCC patients present with metastatic disease at the initial presentation and 50% of them will develop metastasis or recurrence after radical surgery.
METHODS
In an attempt to identify the best predictive marker(s) for metastasis in patients with clear cell RCCs (CRCCs), we examined the expression patterns of 7 metastasis/prognosis-related markers by constructing a tissue microarray including primary CRCC specimens from 30 metastatic and 60 nonmetastatic CRCCs. The markers we studied were Ki-67, MUC1, CD44s, PTEN, gelsolin, CA9 and p53.
RESULTS
The expressions of Ki-67, PTEN, CD44s, gelsolin and p53 were increased, whereas those of MUC1 and CA9 were decreased in the metastatic CRCCs compared with the non-metastatic CRCCs. The receiver operating characteristic curve-area under the curve (AUC) value of Ki-67 was 0.671, which was the highest among the 7 markers. The optimal cut-off value, sensitivity and specificity of the Ki-67 expression were 1.67%, 86.7% and 41.7%, respectively.
CONCLUSIONS
These results demonstrate that the Ki-67 expression was increased in metastatic CRCCs, and it had the highest predictive value among the 7 markers. This suggests that Ki-67 could be an excellent predictive marker for metastasis in CRCC patients.

Mucinous Tubular and Spindle Cell Carcinoma of Kidney Occurring in a Patient with Pulmonary Adenocarcinoma.: Seog Yun Park, Gyeong Hoon Kang, Jae Y Ro, Jennifer Black, Jinsoo Chung, Kang Hyun Lee, Eun Kyung Hong, Weon Seo Park; Korean J Pathol. 2008;42(1):54-59.

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Abstract PDF: Mucinous tubular and spindle cell carcinoma (MTSCC) is a rare type of kidney tumor that has only been recently described. Furthermore, a case of MTSCC associated with a simultaneous lung cancer in the same patient has never been reported in the literature. In this paper, we describe a kidney tumor that was detected during staging work-up in a 72-year-old lung cancer patient. The kidney tumor was removed and shown to exhibit histological and immunophenotypic features of MTSCC, completely distinct from the pulmonary adenocarcinoma. In addition, this case was unique because it was characterized by neuroendocrine differentiation as well as p53 and Ki-67 overexpression in tumor cells. Therefore, we report a case of MTSCC diagnosed in a patient with pulmonary adenocarcinoma and describe the detailed histologic and immunohistochemical features of MTSCC.

Second Opinion Diagnoses of Cytologic Specimens on Consultation : Asan Medical Center Experience.: Sohyung Park, Jae Y Ro, Kyung Ja Cho, Gyungyub Gong, Yong Mee Cho, Shin Kwang Khang; Korean J Cytopathol. 2008;19(2):99-106.; DOI: https://doi.org/10.3338/kjc.2008.19.2.99

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Abstract PDF: BACKGROUND
Second opinion diagnosis of outside pathology slides is a common practice for efficient and proper patient management. We analyzed cytology slides from outside hospitals submitted for a second opinion diagnosis to determine whether the second opinion diagnosis had any influence on patient care.
METHODS
We reviewed 1,153 outside cytology slides referred to Asan Medical Center for second opinions from January, 2007, to December, 2007. All cases were categorized into three groups; no diagnostic discrepancy, minor diagnostic discrepancies (no impact on the management), and major diagnostic discrepancies (significant impact on the management and subsequent follow-up).
RESULTS
The thyroid was the most common organ system (933 cases, 80.9%). Forty cases (3.6%) belonged to the major diagnostic discrepancy group and 149 cases (12.8%) to the minor discrepancy group. For validation of second opinion diagnoses in major discrepancy cases, subsequent biopsy or surgical resection specimens and clinical information were reviewed, which were available in 29 cases. The second opinion diagnoses resulted in alteration of clinical management in 21 of 29 cases.
CONCLUSION
For all referred patients, second opinion diagnosis is important and mandatory for appropriate patient care.

Methylation Patterns of Small Nuclear Ribonucleoprotein Polypeptide N (SNRPN) Related to the Germ Cell Differentiation of Human Germ Cell Tumors.: Sun Young Jun, Kyu Rae Kim, Jene Choi, Jae Y Ro; Korean J Pathol. 2007;41(1):21-29.

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Abstract PDF: BACKGROUND
The histogenesis and interrelationship of the various types of germ cell tumors (GCTs) have been proposed. Dysgerminoma/seminoma (D/S) is a primitive GCT that has not acquired the potential for further differentiation, whereas other types of GCTs are in a dynamic process of differentiation towards a somatic or extraembryonal direction. A primordial germ cell giving rise to a GCT undergoes a developmentally regulated erasure and resetting of imprinted genes, but changes in the imprinting pattern in GCTs as the tumor differentiates have not been well defined. We aimed to investigate the changes of the SNRPN methylation pattern between the germinomas and non-germinomatous GCTs, as compared with the somatic methylation pattern.
METHODS
We used formalin-fixed paraffin-embedded tissue sections of 97 GCTs (18 Ds, 21 Ss, 17 yolk sac tumors (YSTs), 19 immature teratomas, and 22 mature teratomas). DNA methylation was evaluated after bisulfite modification, PCR amplification, and restriction enzyme digestion.
RESULTS
The SNRPN methylation pattern was changed in 53/74 (71.6%) of GCTs as non-somatic patterns. There were significant differences in the methylation pattern between the germinomas and non-germinomatous GCTs, the GCTs being frequently hypo- methylated in Ds/Ss (73.3%), in contrast to the frequent hypermethylation seen in the YSTs and teratomas (47.7%, p<0.05).
CONCLUSIONS
The methylation status of an imprinting gene may be involved in the mechanism causing cellular differentiation and tumorigenesis of GCTs.

ISUP/WHO Classification of Papillary Urothelial Neoplasms of Urinary Bladder: Consensus Study Conducted by Korean Society of Urogenital Pathology.: Jung Weon Shim, Jae Y Ro, Nam Hoon Cho, Young Sik Kim, Yong Wook Park, Sang In Shim, Dong Wha Lee, Yeong Jin Choi, Woon Sup Han; Korean J Pathol. 2006;40(4):282-288.

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Abstract PDF: BACKGROUND
Pathologic grading, one of the most important prognostic factors of papillary urothelial neoplasia (PUN) of the urinary bladder, has been revised continuously. The current study focused on the analysis of interobserver agreement on PUN of the urinary bladder bet- ween 1973 WHO classification (WHO 1973) and 1998 WHO/ISUP classification.
METHODS
Seventy five cases from 15 institutions were collected, and after review by Korean Society of Urogenital Pathology (KSUP), 30 cases were selected as follows; group I, WHO grade 1 and papillary urothelial neoplasm of low malignant potential by ISUP (7 cases), group II, WHO grade 2 and low-grade papillary urothelial carcinoma (16 cases), and group III, WHO grade 3 and high-grade papillary urothelial carcinoma (7 cases). Seventy five general surgical pathologists who participated in this study were asked to grade the tumors based on WHO/ISUP classification. Interobserver agreement between the participants' diagnosis and KSUP consensus diagnosis was analyzed by kappa value.
RESULTS
Interobserver agreement assessed by kappa value for all diagnostic groups was very low; for group I, kappa value was -0.900893722; for group II, -0.944650025, and for group III, -0.876728996. The overall kappa value of pathology residents was better than that of practicing pathologists.
CONCLUSIONS
The 1998 WHO/ ISUP classification could not be easily translated from the 1973 WHO classification and because of poor interobserver agreement, it appears that further work would be needed before it can be practically applied.

A Case of Combined Hepatocellular and Cholangiocarcinoma with Neuroendocrine Differentiation and Sarcomatoid Transformation: A Case Report.: Mi Jung Kim, Hyun Lyoung Koo, Seung Kyu Lee, Jae Y Ro, Eunsil Yu; Korean J Pathol. 2005;39(2):125-129.

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Abstract PDF: We report here on a case of combined hepatocellular and cholangiocarcinoma (CHC) with neuroendocrine differentiation and sarcomatoid transformation. A 59-year-old male who had had HBV-associated chronic liver disease presented with hepatic masses. The explanted liver showed three small masses, two in the right lobe and one in the left lobe. The largest one in the right lobe was a 2.0 cm sized binodular mass,consisting of a yellowish tan nodule and an abutting reddish brown nodule. Microscopically, the reddish brown nodule was a cholangiocarcinoma (CC) showing neuroendocrine differentiation and sarcomatoid tranformation. The yellowish tan nodule and the remaining two masses were hepatocellular carcinoma (HCC)s. On immunohistochemistry, both the adenocarcinoma and spindle sarcomatoid cells were positive for pancytokeratin, but only the adenocarcinoma cells were positive for chromogranin and carcinoembryonic antigen (CEA). Mitotic and Ki67 labeling indices as well as p53 immunopositivity were significantly increased only in the CC component. We report here on the first case of CHC in which the CC displayed neuroendocrine differentiation and sarcomatoid transformation with high mitotic and Ki67-labeling indices, as well as having p53 overexpression.

Epithelioid Myofibroblastoma of Mammary-type in Chest Wall: A Case Report.: Hyun Jung Kim, Hunkyung Lee, Ok Jun Lee, Kyung Ja Cho, Jae Y Ro; Korean J Pathol. 2005;39(2):130-133.

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Abstract PDF: Mammary-type myofibroblastoma of the soft tissue is a benign mesenchymal tumor, and it is a recently established clinical entity. We report a case of myofibroblastoma of the chest wall with a prominent epithelioid feature, that occurred in a 12-year old female. Although the lesion occurred in the breast area, there was no breast parenchyma in or around the mass, which favored soft tissue of the chest wall origin. The tumor was immunohistochemically identical to the mammary-type myofibroblastoma with diffuse and strong positivity against CD34 and desmin. The myoepithelial differentiation of the tumor was further supported by the electron microscopic analysis. This case indicates that mammary-type myofibroblastoma can occur in a young girl. The mammary-type myofibroblastoma should be considered a differential diagnosis, among epithelioid soft tissue neoplasms in the chest wall when the proper immunohistochemical work-up is done.

Myxoma of the Ovary with Uncertain Malignant Potential: A Case Report.: Min A Kim, Ji Hoon Kim, Jae Y Ro, Geunghwan Ahn, In Ae Park; Korean J Pathol. 2004;38(6):434-437.

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Abstract PDF: Primary ovarian myxoid tumor such as myxoma, myxoid liposarcoma and myxoid leiomyosarcoma is extremely rare neoplasm. We experienced a case of unusual myxoid tumor of the ovary in a 25 year-old woman. She was admitted for an incidentally found ovarian mass during antenatal check. Radiologic studies revealed a 5.5x5 cm-sized solid mass in left ovary and she was undertaken left oophorectomy. Grossly, the round ovarian mass was measuring 8x6x5 cm, and the cut surface was predominantly solid with myxoid appearance. Microscopically, the tumor was surrounded by thick collagenous capsule and had moderate cellularity and rich vascularity. The tumor cells were stellate-shaped with abundant extracellular myxoid material without atypia. We initially thought this lesion as myxoma, but the cellularity was too high as an ordinary myxoma. Myxoid liposarcoma could also be considered as the differential diagnosis, however there was no convincing lipoblast. So, we diagnosed that tumor as myxoma with uncertain malignant potential.

Radiation-Induced Epithelial Proliferation Mimicking Invasive Carcinoma of the Urinary Bladder: A Report of 2 Cases.: Ok Jun Lee, Kyu Rae Kim, Dae Woon Eom, Hyun Jung Kim, Na Hye Myong, Jae Y Ro; Korean J Pathol. 2004;38(5):341-344.

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Abstract PDF: Radiation-induced epithelial proliferation in the urinary bladder mimicking urothelial carcinoma has received only a little attention in the literature. Herein, we describe two cases of radiation-induced epithelial proliferative changes, which mimicked invasive urothelial carcinoma. Cystoscopy revealed bullous or edematous mucosal changes with multiple hemorrhagic foci. Microscopically, we observed inverted epithelial proliferation, forming nests and cords extending into the lamina propria. The epithelial cells in these nests and cords exhibited enlarged, hyperchromatic and pleomorphic nuclei, closely mimicking the infiltrative growth of urothelial carcinoma. However, the presence of radiation-induced changes was validated by the observation of abundant vacuolated cytoplasm, normal or slightly increased nuclear to cytoplasmic ratios, the absence of mitotic activity, dilated blood vessels containing frequent fibrin thrombi, scattered atypical fibroblasts, and the patients' previous history of radiation treatment. Radiation-induced changes should be always included in differential diagnoses of proliferative epithelial lesions in the urinary bladder and a pertinent clinical history of radiotherapy should be searched.

Extraskeletal Osteosarcoma of the Posterior Mediastinum: A Case Report.: Weon Cheol Han, Hyang Jung Cho, Jai Kyoo Lee, Hyung Bae Moon, Jae Y Ro; Korean J Pathol. 2004;38(5):350-352.

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Abstract PDF: Extraskeletal osteosarcoma is a rare malignant tumor of soft tissue. In addition, there are only several cases of osteosarcoma of the mediastinum as a primary site in the world. We report a case of extraskeletal osteosarcoma arising in the posterior mediastinum. A 54-year-old man visited our hospital because of chest pain. Chest CT showed a 12 cm sized huge mediastinal mass. The mass revealed solid and ivory-colored cut surface with multifocally ovoid cystic spaces and hemorrhage. Microscopically, the tumor consisted of polygonal stromal cells, giant cells and varying amounts of neoplastic new bone, and mitotic figures were frequently observed. There were no distant metastasis and regional lymph node involvement.

Mixed Ductal-Endocrine Carcinoma of the Pancreas: A Case Report.: Ok Jun Lee, Yong Mee Cho, Hyang Im Lee, Duck Jong Han, Jae Y Ro; Korean J Pathol. 2004;38(5):353-356.

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Abstract PDF: Mixed ductal-endocrine carcinoma of the pancreas is composed of ductal and endocrine carcinoma components and each component makes up a significant proportion in the primary tumor as well as in the tumor of metastatic sites. Mixed ductal-endocrine pancreatic carcinoma is exceptionally rare and, to our knowledge, only five cases have been reported in the literature. Recently we experienced a case of mixed ductal-endocrine pancreatic carcinoma with regional lymph node and hepatic metastases in a 63-year-old woman. Here, we report a case of mixed ductal-endocrine pancreatic carcinoma with a review of the literature.

Oncocytic Glomus Tumor: A Case Report.: Na Rae Kim, Jae Y Ro, Dong Hae Chung; Korean J Pathol. 2004;38(4):268-269.

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Abstract PDF: Oncocytic glomus tumor is a newly recognized, rare variant of glomus tumor. In this study, we describe a case of oncocytic glomus tumor occurring in the nail bed of the finger. A 25-year-old woman presented with a tiny and painful mass on her hand, and she had had this lesion for six years. Upon microscopic examination, there were oval to polygonal tumor cells characterized by plump eosinophilic granular cytoplasm, which were arranged in sheets around the thin vessels. Immunohistochemically, the tumor cells were strongly reactive for smooth muscle actin, vimentin, and negative for S-100 protein, alpha-fetoprotein, HMB-45, desmin, CD34, and pancytokeratin. The diagnosis was a glomus tumor of the oncocytic variant.

Dermatofibrosarcoma Protuberans of the Parotid Gland: A Case Report.: Ok Jun Lee, David Y Pi, Daniel H Jo, Kyung Ja Cho, Sang Yoon Kim, Jae Y Ro; Korean J Pathol. 2004;38(4):276-279.

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Abstract PDF: Dermatofibrosarcoma protuberans (DFSP) typically presents during the early or mid-adult life, and the most common site of origin is the skin on the trunk and proximal extremities. DFSP of the parotid gland is extremely rare and only one case has been reported in the literature. We present here a case of a 30-year-old woman with DFSP occurring in the parotid gland, and we discuss the differential diagnosis. The patient is alive and doing well one year after her operation.

Urachal Adenocarcinoma with a Concomitant Urachal Remnant: A Case Report.: Tae Hoon Kim, Mee Joo, Min Kyung Kim, Hanseong Kim, Je G Chi, Jae Y Ro; Korean J Pathol. 2004;38(4):280-283.

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Abstract PDF: Urachal adenocarcinoma is a rare tumor, and it has similarities with nonurachal adenocarcinoma; therefore, it is sometimes difficult to make a diagnosis. We present a typical case of urachal adenocarcinoma that had all the diagnostic criteria including the presence of an urachal remnant. A 65-year-old woman presented with complaints of a painless gross hematuria. Pelvic CT and cystoscopy showed an intraluminal protruding mass centered in the bladder wall. When diagnosed as adenocarcinoma with a signet ring cell component being noted by frozen biopsy, partial cystectomy with resection of the median umbilical ligament and peritoneum was carried out for a suspected urachal adenocarcinoma. The tumor morphology showed as typical mucinous adenocarcinoma. Characteristic tubular structures showing the typical histology of an urachal remnant was found in the perivesical fat. On immunohistochemical staining, the urachal adenocarcinoma showed a pattern similar to colonic adenocarcinoma, while the urachal remnant showed strong positivity for CK7 and Chromogranin A.

Localized Amyloidosis of the Ureter: A Report of Two Cases.: Ho Jung Lee, Dong Eun Song, Jong Eun Joo, Won Mi Lee, Dong Hoon Kim, Eun Kyung Kim, Jae Y Ro; Korean J Pathol. 2004;38(3):184-187.

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Abstract PDF: We report on two cases of localized amyloidosis involving the ureter. The patients were a 64-year-old woman with right upper quadrant pain (case 1) and a 36-year-old woman suffering from left flank pain and intermittent gross hematuria (case 2). An intravenous pyelography of case 1 revealed multiple filling defects in the entire right ureter, whereas retrograde pyelography in case 2 showed diffuse narrowing in the mid and lower portions of the left ureter. Localized amyloidosis of the ureter was diagnosed in the two cases, and both had amyloid deposit in the renal pelvis and the urinary bladder in case 1, and in the contralateral ureter and the renal pelvis in case 2. Right nephroureterectomy was performed in case 1, but a segmental resection of the ureter with preservation of the kidney was administered in case 2. These two cases demonstrate that ureteral amyloidosis can be associated with amyloid deposition in the renal pelvis and the urinary bladder. Although ureteral amyloidosis is a rare occurrence, it should be considered in the differential diagnosis of ureteral obstruction to avoid unnecessary radical surgery.

Mesothelial Cell Inclusions Mimicking Metastatic Carcinoma in Mediastinal Lymph Node: A Case Report.: Young Min Kim, Kyu Rae Kim, Jae Y Ro; Korean J Pathol. 2004;38(1):46-49.

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Abstract PDF: The presence of benign mesothelial cell inclusions in the mediastinal lymph node is extremely rare and thus difficult for the pathologist distinguishing from sinus histiocytosis, metastatic carcinoma, or metastatic mesothelioma. We recently had a case of benign mesothelial cell inclusions in the mediastinal lymph node, which is initially misinterpreted as metastatic carcinoma of unknown origin. However, further clinical studies failed to identify the primary site. Subsequent immunostaining with calretinin demonstrated the strong nuclear and cytoplasmic immunore-activity, suggesting that these cells are mesothelial cells. It is important that when the nodal changes resemble metastatic carcinoma morphologically in the mediastinal lymph nodes, but the primary site can not be identified clinically, the possibility of mesothelial cell inclusions should be raised and the proper use of immunohistochemistry in conjunction with a clinical finding is recommended.

Second Opinion Diagnostic Discrepancy in Surgical Pathology: Asan Medical Center Experience.: Young Min Kim, Kyung Ja Cho, Sun Young Jun, Mi Sun Choe, Shin Kwang Khang, Jae Y Ro; Korean J Pathol. 2003;37(5):301-306.

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Abstract PDF: BACKGROUND
Review of the outside pathology material is an important practice that provides useful information on patient managements and improves the diagnostic quality in surgical pathology. We report our experience with the frequency and types of diagnostic discrepancies in patients referred to the Asan Medical Center for treatment or a second opinion.
METHODS
All referral pathology diagnoses (867 surgical cases) made from October 2001 to July 2002 at Asan Medical Center were compared with outside pathology diagnoses.
RESULTS
Of the 867 surgical cases reviewed, 231 (26.7%) cases had a diagnostic discrepancy, which included 49 (5.7%) major and 182 (21.0%) minor discrepancies. The contents of the major discrepancies were a change in the diagnosis (34 cases), a change in the type of malignancy including small cell carcinoma and non-small cell carcinoma of the lung (10), a diagnosis of a metastasis as the primary lesion (4), and errors in interpreting the invasiveness (1). The causes or reasons for the major discrepancy were a difference in interpretation (81.6%), the availability of special studies (10.2%), a failure to identify the lesions (4.1%), and a lack of clinical information (4.1%).
CONCLUSIONS
The major discrepancy rate (5.7%) was comparable to that of the other reports from western countries. Among the major discrepancies, a change in diagnosis was most commonly observed and difference in interpretation was the most common reason. A routine review of all the patients pathology material is recommended for all referral patients for an improvement in the pathologic diagnoses and to provide better medical care.

Endolymphatic Sac Tumor: A Case Report.: Dae Woon Eom, Jae Y Ro, Shin Kwang Khang, Chang Jin Kim, Kyung Ja Cho; Korean J Pathol. 2003;37(5):351-354.

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Abstract PDF: Endolymphatic sac tumor (ELST) is a very rare adenomatous tumor of the temporal bone histologically characterized by a typical papillary pattern. This tumor often shows a locally aggressive growth and recurrence despite its relatively benign histology. We report a case of endolymphatic sac tumor of the right jugular foramen in a 50 year-old male. Microscopically, the tumor was composed of uniform cuboidal to low columnar epithelial cells arranged in an arborizing papillary pattern. Under immunohistochemistry, the tumor cells were positive for cytokeratin, CD56, epithelial membrane antigen, neuron specific enolase, and vimentin.
Discussion
on the classification and histogenesis of adenomatous tumors of the middle ear and temporal bone has been active in western countries during the recent decades; however, these tumors have been very unusual in Korea. This is the second report of ELST in Korea, and consists of a discussion on related problems.

Renal Malakoplakia with Secondary Hepatic Extension: A Case Report.: Dong Eun Sung, Eunsil Yu, Chung Su Kim, Jae Y Ro; Korean J Pathol. 2003;37(3):199-203.

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Abstract PDF: Renal malakoplakia (RM) with secondary hepatic involvement is extremely rare. There are only two cases reported in literature. We report the first case of RM with secondary hepatic extension in Korea. A 70-year-old woman had a history of long-term oral steroids intake. A radical nephrectomy and a segmental hepatectomy were performed under the clinical impression of a renal cell carcinoma with hepatic extension on the dynamic liver computed tomography. The gross specimen revealed a lobulated yellowish-tan, soft mass (9 X 8 X 5 cm) with hepatic involvement in the upper pole of the right kidney. The hematoxylin and eosin, Prucian blue and von-Kossa stainings, and electron microscopy demonstrated the classical histologic features of malakoplakia with Von Hansemann histiocytes containing Michaelis-Gutmann bodies. The patient is well 5 months after surgery. This case emphasizes that initial diagnoses can be difficult because of the rare occurrence of RM and its resemblance to renal cell carcinoma with hepatic extension.

Pleomorphic Liposarcoma of the Kidney: A Case Report.: Mi Jung Kim, Hyun Lyoung Koo, Sun Young Jun, Jae Y Ro; Korean J Pathol. 2003;37(3):210-213.

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Abstract PDF: Although the liposarcoma is a common malignant mesenchymal tumor of the retroperitoneum, its occurrence in the kidney is very rare. A few cases involving only the renal parenchyma have been reported. The histologic features of these cases are not different from those of other body sites. We report a case of pleomorphic liposarcoma arising in the kidney of a 36-year-old man. He had been suffering from pain in the right flank for two weeks. A computed tomographic scan demonstrated a large mass in the right kidney. He underwent a radical nephrectomy under the clinical impression of renal cell carcinoma. There was a 11 cm-sized well demarcated solid mass in the lower pole of the right kidney. Microscopically, the tumor consisted of pleomorphic spindle and epithelioid cells with focal areas showing distinct adipocytic differentiation and geographic necrosis. A few diagnostic lipoblasts were present. Despite extensive search on samples, no carcinomatous component was found. Immunohistochemically, all of the tumor cells were negative for cytokeratin but positive for vimentin. Lipoblasts were positive for S-100 protein as well as for vimentin. When the kidney tumor is exclusively sarcomatous, a generous sampling with proper immunohistochemical staining is recommended to differentiate a primary sarcoma of the kidney from a sarcomatoid carcinoma.

Solitary Fibrous Tumor of Meninges in Pituitary Fossa: A Case Report.: Dae Woon Eom, Shin Kwang Khang, Chang Jin Kim, Jae Y Ro; Korean J Pathol. 2003;37(2):137-140.

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Abstract PDF: Solitary fibrous tumor (SFT) was originally described in the pleura. An increased number of extrapulmonary sites of SFTs has been described. We report a case of SFT of the meninges in the pituitary fossa. A 56-year-old man was admitted with a severe headache and visual disturbance. The tumor, with osteolytic bony change, was 3.5 cm in greatest dimension and extended from the sphenoid sinus to the third ventricle level. Histologically, the tumor showed the typical features of a solitary fibrous tumor with no evidence of being high grade. By immunohistochemical study, the tumor cells were positive for CD34, vimentin, and Bcl2, but were negative for epithelial membrane antigen and S-100 protein. When fibrous tumors or tumors with hemangiopericytic vascular pattern involve the meninges, the possibility of their being SFTs should be considered, and a proper immunostaining is recommended. To our knowledge, ours is the first description of a case of SFT occurring at the meninges in the pituitary fossa.

Primary Primitive Neuroectodermal Tumor of the Kidney: Report of Two Cases.: Hyun Lyoung Koo, Sun Young Jun, Gene Choi, Jae Y Ro, Hanjong Ahn, Kyung Ja Cho; Korean J Pathol. 2003;37(2):145-149.

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Abstract PDF: Primitive neuroectodermal tumor (PNET) is a small round cell neoplasm that mainly develops in the central nervous system and soft tissue of children. Primary occurrence in the kidney is rare and the identification of immunopositivity for CD99 and t(11;22)(q24;q12) is essential in differential diagnoses. We report two cases of PNET developed in a 21-year-old woman and a 44-year-old man. Resected tumors were composed of sheets of round or ovoid cells with hyperchromatic nuclei and minimal eosinophilic cytoplasm. Rosette formations, more prominent in the first case, were observed. The tumor cells of both cases were diffusely positive for CD99, vimentin, and neuron specific enolase, while they were negative for cytokeratin, desmin, and chromogranin. Synaptophysin was focally expressed only in the first case. The EWS-FLI1 chimeric gene was identified by a reverse transcriptase-polymerase chain reaction in the first case. The first patient is alive with a recurrent tumor two years after the diagnosis, and has received combination chemotherapy. The second patient is alive with no evidence of recurrence or metastasis nineteen months after the diagnosis.

Immunophenotype of Thymic Epithelial Tumors According to the New World Health Organization Classification.: Sung Hye Park, Han Seong Kim, Han Kyeom Kim, Bong Kyung Shin, Seung Mo Hong, Jae Y Ro; Korean J Pathol. 2001;35(4):278-285.

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Abstract PDF: BACKGROUND
To identify the expression patterns and usefulness of various antibodies in making diagnoses and predicting prognoses, an immunohistochemical study was performed on thymic epithelial tumors (TETs).
METHODS
Forty-two cases of TETs were reclassified according to the new World Health Organization (WHO) classifications. CD3, CD5, CD79a, CD99, pan-, high- and low-molecular weight cytokeratins, EMA, vimentin, MIB-1 (Ki67) and p53 immunostaining were carried out.
RESULTS
There were two, twelve, eight, two, thirteen and one case for type A, AB, B1, B2, B3 and C, respectively. Combined B1/B2 and B2/B3 were 2 cases each. Fourteen cases (33.3%) had myasthenia gravis. CD99 was immunoreactive mainly in cortically derived lymphocytes, while CD3 and CD5 were immunoreactive in medullary-derived lymphocytes. CD5 immunoreactivity was negative in all thymic epithelial cells, except for one case of type B3. MIB-1 indices were highly expressed in cortical lymphocytes and some thymic epithelial cells, but did not show any correlation with grades. p53 in thymic epithelial cells was expressed in 6 (46%) out of 13 cases of type B3 and one case of type C, and it was negative in all other subtypes.
CONCLUSIONS
Only p53 was helpful for predicting high grades (B3 and C) (P<0.05). By MIB-1 indices, we could tell how many cortical immature lymphocytes were occupied in TETs, however, grading could not be achieved.

Adenoid Basal Cell Tumor of the Prostate: A case report.: Joo Heon Kim, Woo Sung Moon, Myoung Jae Kang, Dong Geun Lee, Jae Y Ro; Korean J Pathol. 2000;34(7):534-536.

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Abstract PDF: Adenoid basal cell tumor of the prostate is a rare tumorous lesion that can be misdiagnosed as adenocarcinoma of the prostate. The malignant potential of adenoid basal cell tumor remains uncertain due to small number of reported cases. This 66-year-old man presented with symptoms of urinary tract obstruction. Under the impression of benign prostatic hyperplasia, a transurethral resection of the prostate (TURP) was performed. The patient was alive with no evidence of recurrence or metastasis 15 months after TURP. Microscopically, most of the lesions were composed of nodular collections of small nests of basaloid cells with peripheral palisading, and clusters of tumor cells forming cribriform pattern. Multiple areas of basal cell hyperplasia and atypical basal cell hyperpalsia were also observed. The coexistence of basal cell hyperplasia, atypical basal cell hyperpalsia, and adenoid basal cell tumor with cribriform pattern in this case supports a morphologic continuum from the benign hyperplastic lesion to malignant neoplasia.

Clinicopathologic Significance of Lymph Node Micrometastasis in Advanced Gastric Carcinoma.: Youngmee Kwon, Jae Y Ro, Gyeong Hoon Kang; Korean J Pathol. 2000;34(2):125-131.

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Abstract PDF: There have been some controversies on prognostic significance of lymph node (LN) micrometastasis (MM) in advanced gastric carcinomas (AGCs). The present study aimed at 1) determination of prognostic significance of MM, 2) evaluation of the relationship between MM and clinicopathological parameters, and 3) determination of LN group where MMs were frequently found. We studied 70 cases of AGC without LN metastasis on initial examination. The tumors were examined for location, size, depth of invasion, differentiation, histologic type, lymphatic invasion, and c-erbB-2 expression. To evaluate MM, pancytokeratin immunohistochemistry was performed in all LNs from 70 cases of AGCs. Among 2,203 dissected LNs from 70 patients, 37 (1.6%) LNs from 19 (27.1%) patients revealed MM. Micrometastases were seen in only group 1 and 2 LNs: none had group 3 and 4 LN involvement. The gender, age, tumor size, location of tumor, histologic type, differentiation, depth of invasion, lymphatic invasion, and c-erbB-2 expression were not significantly associated with MM status. The survival time of the MM-positive group (mean: 62 months) was significantly shorter than that of the MM-negative group (mean: 72 months) (p=0.046). The findings of this study indicate that the presence of MM in LNs is an important prognostic factor in AGC patients.

Fine Needle Aspiration Cytology of Pulmonary Hamartoma.: Tae Jin Lee, Jin Sook Lee, Gyung Yub Gong, Shin Kwang Khang, Jae Y Ro; Korean J Cytopathol. 2000;11(1):19-24.

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Abstract PDF: Pulmonary hamartomas are uncommon benign tumors, usually discovered radiologically as a solitary coin lesion in asymptomatic individual. The approach to the patient with a peripheral lung nodule has changed with the increasing acceptance of fine needle aspiration cytology(FNAC) as a rapid, safe, inexpensive, and highly accurate diagnostic tool. However, a few reports describing the FNAC findings of pulmonary hamartoma have appeared in the cytologic literature and the experience of FNAC is limited. We reviewed all 9 cases of pulmonary hamartoma with histologic confirmation after FNAC seen at Asan Medical Center since 1995 to evaluate cytologic findings and to determine the value of FNAC in identifying that lesion. Originally, seven of nine patients were diagnosed as pulmonary hamartoma, while two patients were diagnosed as inflammatory lesion and adenocarcinoma of each. On review, eight of nine patients were considered as diagnostic of pulmonary hamartoma. The diagnostic findings in FNAC of pulmonary hamartoma were the presence of fibrillary myxoid tissue with spindle cells as well as hyaline cartilage.

Clinicopathologic Features of Prostatic Adenocarcinoma: A Study of 58 Radical Prostatectomy Specimens.: Tae Jin Lee, Mi Sun Choe, Choung Soo Kim, Jae Y Ro; Korean J Pathol. 1999;33(11):1067-1075.

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Abstract PDF: Prostatic carcinoma is the most commonly diagnosed cancer in the United States in men. Prostatic carcinoma in Korean men is uncommon and accounts for less than 1% of total cancer: however, the incidence of prostatic carcinoma is continuously increasing. Several clinicopathologic parameters including stage, Gleason score, and serum PSA level have been widely accepted as well established prognostic factors. To study the clinicopathologic features of prostatic carcinoma in Korean men, 58 cases of prostatic carcinoma, which were diagnosed on radical prostatectony specimens at Asan Medical Center from Jan. 1993 to June 1998 (1993; 3 cases, 1994; 3, 1995; 6, 1996; 12, 1997; 24, 1998; 10), were evaluated. The prostatic carcinomas were divided into three groups according to Gleason score. Tumors with Gleason score 6 or lower, 7, and 8 to 10 were categorized as low-grade, intermediate-grade and high-grade tumor, respectively. The overall mean age of the patients was 62.6 years (range, 4 6~76 years); mean age was 65.4, 62.8 and 61.1 in low, intermediate and high-grade tumor, respectively (p>0.05). The overall mean serum PSA level was 38.6 ng/ml (range, 0.3~276.0 ng/ml); mean serum PSA level was 17.0, 29.0 and 60.9 ng/ml in low, intermediate and high-grade tumor, respectively (p=0.002). The mean T stage was 2.3, 2.4 and 3.1 in low, intermediate and high-grade tumor (p=0.001). The percentage of positive resection margin was 33.3, 50.0 and 91.0 % in low, intermediate and high-grade tumor (p=0.001). The overall presence of prostatic intraepithelial neoplasia (PIN) was 79.3 %; percentage of the presence of PIN was 100, 79.2 and 68.2 % in low, intermediate and high-grade tumor (p>0.05). As reported in the literature, our results indicated that Gleason score was a good predictor of stage and prognosis. The higher Gleason score, the more cases were with positive surgical margins, advanced pathologic stage, and high serum PSA level (p<0.05).

Verumontanum Mucosal Gland Hyperplasia: A case report.: Mi Sun Choe, Tae Jin Lee, Eun Sil Yu, Jae Y Ro; Korean J Pathol. 1999;33(9):737-740.

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Abstract PDF: Verumontanum mucosal gland hyperplasia (VMGH) is a relatively common benign proliferative lesion which was first described by Gagucas et al in 1995. VMGH is usually found in radical prostatectomy or transurethral resection specimens and rarely in needle biopsy specimens. The histologic feature of VMGH is characterized by well-circumscribed proliferation of small glands and thus VMGH may mimic low grade adenocarcinoma. We report a case of VMGH from a 61-year-old man. The lesion coexisted with prostatic adenocarcinoma on radical prostatectomy specimen. The lesion was a well circumscribed microacinar proliferation which was present between the openings of ejaculatory ducts. The acini consisted of two cell layers with inner secretory cuboidal epithelium and outer basal cell. Typically, the lumen contained many corpora amylacea. Nuclear pleomorphism, prominent nucleolus, or mitotic figure was not identified. Because of small gland proliferation of VMGH, this lesion can be confused with other small gland proliferative lesions, such as low grade adenocarcinoma, atypical adenomatous hyperplasia, basal cell hyperplasia, mesonephric hyperplasia, and nephrogenic adenoma. To avoid misdiagnosis of VMGH as carcinoma, one should be familiar with this lesion.

Prostatic Tissue in Ovarian Mature Cystic Teratoma: A case report.: Seung Mo Hong, Mi Sun Choe, Eun Mee Han, Hun Kyung Lee, Jae Y Ro; Korean J Pathol. 1999;33(7):525-528.

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Abstract PDF: Ovarian mature cystic teratoma containing benign prostatic tissue is rare and only 11 cases have been reported in the literature to date. We report a case of mature cystic teratoma of the ovary containing prostatic tissue. A 23-year-old female patient came to our hospital complaining of irregular menstruation for 3 months. Her menarche had occurred when she was 13 years old. The patient showed no evidence of virilization nor of endocrinopathy. A goose-egg-sized mass was palpable in the left lower abdomen on physical examination. Ultrasonography revealed a cystic ovarian mass with internal echogenecity. Microscopic finding was consistent with that of usual mature cystic teratoma except for a 1.5 cm focus of prostatic and bladder tissues. Prostatic tissue demonstrated strong immunoreactivity for prostatic specific antigen (PSA), prostatic alkaline phosphatase (PAP) and cytokeratin 7. Basal cells of the prostate glands were positive for high molecular weight cytokeratin (34betaE12). Although ovarian mature cystic teratoma containing prostatic tissue has been reported as a rare occurrence, a careful examination with immunohistochemical staining may increase the detection of prostatic tissue in mature cystic teratoma of the ovary.

Solitary Fibrous Tumor of the Scrotum: A case report.: Jung Weon Shim, Jae Y Ro; Korean J Pathol. 1999;33(4):295-298.

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Abstract PDF: Solitary fibrous tumor (SFT) is a rare spindle cell neoplasm that usually arises in the pleura and has been recently reported from unusual locations. We present a case of SFT that occurred in the scrotum. The patient was a 38-year-old man who presented with a painless, left, scrotal mass of five years' duration. Scrotal sonography and pelvic CT scan showed a soft-tissue mass of 11 cm in diameter. The resected tumor measured 11 8 7 cm and was well demarcated from the surrounding soft tissue. The cut surface revealed homogenously grayish-white and gelatinous appearance. No hemorrhage or necrosis was found. Microscopically, the tumor showed hypercellular spindle cell areas intermixed with hypocellular areas lying in a myxoid or collagenous stroma. The spindle cells had no mitosis or low mitotic figures, and little or no nuclear atypia. They exhibited a variety of growth patterns, including "patternless" pattern, and a prominent vasculature with hemangiopericytic pattern. Vimentin, CD34, and bcl-2 protein immunoreactivity were observed. Characteristic histologic and immunohistochemical features of this lesion were consistent with SFT. To arrive at a correct diagnosis of this lesion, especially when it occurs in unusual sites, immunohistochemical study including CD34 & bcl-2 protein is required in addition to characteristic histologic features.

A Cytomorphologic Study of Benign and Malignant Papillary Neoplasms of the Breast.: Ho Jung Lee, Gyungyub Gong, Bohng Hee Kim, Sei Hyun Ahn, Jeong Mi Park, Jooryung Huh, Shin Kwang Khang, Jae Y Ro; Korean J Cytopathol. 1999;10(1):27-34.

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Abstract PDF: Benign and malignant papillary neoplasms of the breast may be difficult to distinguish in both cytologic and histologic preparations. To define the cytologic features of benign and malignant papillary lesions, we retrospectively reviewed 18 cases of fine needle aspirates from histologically confirmed cases of papilloma or papillary carcinoma of the breast. This study included 3 intraductal papillary carci nomas, 3 invasive papillary carcinomas, and 12 intraductal papillomas. All cases were evaluated for presence or absence of papillary fragments, bloody background, apocrine metaplasia, macrophages, and degree of cellularity, atypia, and single isolated columnar epithelial cells. Papillary fragments were present in all cases. The background of the smear was bloody in all 6 carcinomas, but in only 7 out of 12 papillomas. Markedly increased cellularity was present in 4 carcinomas(67%) and 7 papillomas(58%). Single cells were present in 5 carcinomas(83%) and 8 papil lomas(67%). The majority of papillomas and papillary carcinomas had mild to moderate atypia, and severe atypia was noted in one case of intraductal papillary carcinoma and one case of invasive papillary carcinoma. Apocrine metaplasia was absent in all cases of papillary carcinomas, but present in 8 papillomas(67%). Macrophages were noted in 4 carcinomas and were present in all cases of papillomas. The constellation of severe atypia, bloody background, absence of apocrine metaplasia and/or macrophages were features to favor carcinoma. Malignant lesions tended to show higher cellularity and more single isolated cells. The cytologic features mentioned above would be helpful to distinguish benign from malignant papillary lesions of the breast. However, because of overlapping of cytologic features, surgical excision should be warranted in all cases of papillary lesions of the breast to further characterize the tumor.

Metastasis of Carcinoma to Carcinoma.: Sang Sook Lee, Jae Y Ro; Korean J Cytopathol. 1985;19(4):453-457.

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Abstract PDF: Two unusual cases of metastasis of carcinoma to carcinoma are reported. The initial malignancies, an adenocarcinoma of the rectum and a duct carcinoma of the breast, were found to have metastasis to a clear cell carcinoma of the kidney. The various theories on the peculiar tendency for the renal cell carcinoma to be the most common host tumor for other primary carcinoma are commented upon briefly.

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