Journal of Pathology and Translational Medicine

Je Geun Chi

45 Articles

Cytological Diagnosis of Lung Cancer: The Diagnostic Accuracy and Pitfalls.: Hyun Sook Chi, Je Geun Chi; Korean J Cytopathol. 2008;19(1):1-8.; DOI: https://doi.org/10.3338/kjc.2008.19.1.1

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The role of respiratory cytology is to detect and classify pulmonary disease, with an emphasis of neoplastic disease, so that proper therapy can be instituted. As in many branches of cytology, the recognition of malignancy in the cells obtained from the respiratory tract is more straightforward than identifying the type of tumor cell. It is important to accurately determine the true cytopathological cell type in cases of primary lung cancer and to know the accuracy of the diagnosis achieved by the cytological procedures. The well differentiated tumors have characteristic cytoplasmic and nuclear abnormalities that enable physicians to firmly categorize these lesions, as in squamous cell or adenocarcinoma, but some moderately and most poorly differentiated tumors show few distinctive features. This article reviews the malignant and reactive pulmonary cytologic findings and we also report on some of their pitfalls and the cytologic criteria.

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Fine Needle Aspiration Cytology of Metastatic Adenocarcinoma of the Gingiva from the Lung: A Case Report
Tack Kune You, So Ri Kim, Ho Sung Park, Kyu Yun Jang, Woo Sung Moon, Myoung Ja Chung, Dong Geun Lee, Myoung Jae Kang
Korean Journal of Pathology.2012; 46(1): 101. CrossRef

Fine Needle Aspiration Cytology of Subacute Granulomatous Thyroiditis: A Clinico-Cytological Review of 10 Cases with Immunocytochemical Analysis.: Eun Hee Suh, Seong Hoe Park, Je Geun Chi; Korean J Cytopathol. 2008;19(1):27-33.; DOI: https://doi.org/10.3338/kjc.2008.19.1.27

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Abstract PDF: Although subacute granulomatous thyroiditis(SGT) is usually diagnosed clinically, papillary carcinoma or other thyroid conditions must be considered in the differential diagnosis. We retrospectively reviewed the clinical and fine-needle aspiration(FNA) cytologic findings seen in 10 SGT cases to decide what are the most reliable cytologic findings and the most helpful molecular tools for reaching a confident cytologic diagnosis. The most representative smear slides were retrieved to perform immunocytochemistry for cytokeratin19(CK19) and Ret protein. Five papillary carcinomas(PTCs) were included as controls. The constant and typical cytologic findings of SGT were multinucleated giant cells(MGCs) (100%), epithelioid granulomas(90%), an inflammatory dirty background(90%) and plump transformed follicular cells(80%) without fire-flare cells, oncocytic cells or transformed lymphocytes. The immunoreactivities for CK19(37.5%) and Ret(10%) of the follicular cells of SGT were less than those(CK19 and Ret:100%) of PTC. CK19 immunoreactivity of the MGCs was seen in only one case of PTC. There was no significant difference between CK19 and Ret immunocytochemical staining for the MGCs of both SGT and PTC. The results of this study demonstrate that the cytological diagnosis of SGT can be improved by employing a combination of the typical and constant diagnostic cytological features and immunocytochemical results.

Improved Technique of Digoxigenin Labeled RNA in situ Hybridization.: Suk Keun Lee, Yeon Sook Kim, In Sun Song, Sang Shin Lee, Young Jun Lee, Woo Ho Kim, Je Geun Chi; Korean J Pathol. 2001;35(2):98-110.

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Abstract PDF: BACKGROUND
A practical RNA in situ hybridization method using digoxigenin labeled RNA probes is described in order to evaluate the technical difficulties and problems in RNA in situ hybridization.
METHODS
The paraffin sections, routinely processed in the Pathology Laboratory, were tested for the possibility of RNA in situ hybridization instead of the RNase free paraffin sections, fixed in 4% paraformaldehyde and prepared using RNase protection procedures.
RESULTS
Most of the paraffin sections, fixed in 10% neutral formalin solution in fresh condition, showed relatively good reaction of RNA in situ hybridization, although the necrotic tissue and autopsy specimens showed poor reaction of RNA in situ hybridization. A refixation procedure using a 4% paraformaldehyde solution was evaluated for optimal expression of mRNA in the paraffin sections.
CONCLUSION
The treatment of 4% paraformaldehyde before the treatment of proteinase K showed better in situ hybridization than did the treatment of 4% paraformaldehyde after the treatment of proteinase K. Also a new Polymerase Chain Reaction (PCR)-based method of RNA probe production showed consistently good results.

Perianal Granuloma Caused by a Female Pinworm (Enterobius vermicularis): A case report.: Seok hyung Kim, Je Geun Chi; Korean J Pathol. 2000;34(8):605-607.

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Abstract PDF: The intestinal nematode Enterobius vermicularis is the most common metazoan endoparasite in humans, with humans being the only host. But complicated perianal granulomas due to Enterobius are unusual. The literature reports only 13 previous cases of enterobiasis presenting as perianal mass or abscess. We describe an additional case of a perianal mass caused by granulomatous inflammation containing Enterobius vermicularis eggs and dead bodies in a 7-year-old boy. The lesion was located in the anus and measured 2 1 cm. Clinical impression was lipoma and excisional biopsy was done. Microscopic examination revealed necrotizing granuloma which contained several 50~60 20~30 micrometer sized eggs which were identified as those of Enterobius vermicularis. The adult worm could not be identified with clarity due to necrosis.

Cytologic Features and Distribution of Primary Sites of Malignant Cells in Cerebrospinal Fluid .: Yeon Mee Kim, Mi Yeong Jeon, Je Geun Chi; Korean J Cytopathol. 2000;11(2):65-73.

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Abstract PDF: Cytologic evaluation of cerebrospinal fluid(CSF) is an effective mean for diagnosing many disorders involving the central nervous systems(CNS). One of the most important reasons for cytologic examination of CSF is to detect metastatic or primary neoplasms of the CNS. We did a retrospective study of 1,438 CSF specimens obtained between 1992 and 1996. A total of 1,205 adult and 233 pediatric CSF specimens from 947 patients were accessed at the Department of Pathology of Seoul National University Hospital and Children's Hospital, respectively. Among 1,438 CSF cytology specimens, 169 cases(11.8%, 77 patients) including 135 adult cases(59 patients) and 34 pediatric cases(18 patients) were positive for malignant cells. Diagnoses included 60 metastatic carcinomas(adult, 60; pediatric, 0); 46 malignant lymphomas(adult, 44; pediatric, 2); 21 leukemias(adult, 20; pediatric, 1); 4 retinoblastomas(adult, 0; pediatric 4); 2 rhabdomyosarcomas(adult, 0; pediatric, 2); 1 multiple myeloma(adult, 1; pediatric, 0), and 35 primary CNS neoplasms(adult, 10; pediatric, 25). The most commonly identified metastatic carcinomas in adults were adenocarcinoma. Their primary sites were the lung, gastrointestinal tract, and breast in order of frequency. The most common primary CNS neoplasm in children was medulloblastoma.

Expression of Laminin Chains in the Neuronal Cells of Mouse Brain.: Gi Jin Kim, Yong Jin Choi, Suk Keun Lee, Je Geun Chi; Korean J Pathol. 1999;33(12):1163-1174.

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Abstract PDF: Laminin-1 is biologically active and can effect cellular proliferation, differentiation, migration, and apoptosis. In the central nervous system, neuronal cells are rarely reported to give positive reaction by laminin antibody staining. However, the original cell type which can produce the laminin molecule has not been well established. Since the neuronal cells of brain are derived from neuroectoderm, we thought that the neuronal cells should be able to produce the laminin molecules as other epithelial cells. In this study we aimed to explore whether the neuronal cells express the laminin chain mRNAs, and further to identify which types of laminin isoform are expressed at the specific sites of the brain structure. We found that neuronal cell was the important cell type in mouse brain, which could produce laminin isoforms. Although immunostainings disclosed reactivity of laminins in the basement membrane of capillaries as well as neuronal cells, mRNA expressions of laminins were intense only in the neuronal cells. It was relatively weak in the endothelial cells. Among neuronal cells the cortical cells of cerebrum, pyramidal cells of hippocampus, and Purkinje cells of cerebellum showed pronounced expression of laminin chain mRNA. Glial cells, especially astrocytes, were negative for laminin subtypes both in immunohistochemistry and in situ hybridization. Taken together, our data indicate that the neuronal cells of mouse brain actively produce laminin isoforms, and the resultant polymerized laminins are accumulated mainly in the basement membrane of capillaries. In conclusion, the results indicate that neuronal cells produce and utilize the different laminin chains to maintain the neurovascular environment of brain.

Cerebral Amyloid Angiopathy: A report of two cases.: Kee Taek Jang, Ghee Young Choe, Yeon Lim Suh, Je Geun Chi; Korean J Pathol. 1999;33(9):741-744.

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Abstract PDF: Cerebral amyloid angiopathy (C.A.A) is characterized by the extracellular amyloid protein deposition in the vessel walls of the brain and meninges. It has been estimated to account for 5 to 10% of all primary, nontraumatic brain hemorrhage. We report two cases of C.A.A causing nontraumatic intracerebral hemorrhage in the frontal lobe. The first case was a 60-year-old female who was admitted for the left hemiplegia and dysarthralgia. Brain CT revealed right frontal lobe hemorrhage. The second case was a 72-year-old male who was admitted for amnesia and gait disturbance. Clinical impression was Alzheimer's disease. Brain MRI revealed multifocal small hemorrhage in the right frontal lobe. Microscopically, both cases showed dilated small arteries of superficial cortex and meninges with hyalinization. Some vessels showed microaneurysm and fibriniod necrosis. Congo-red stain also exhibited birefringence under polarized light. There was no evidence of Alzheimer's disease.

Abnormal Development and Apoptosis Observed in Brains of the Trisomy 16 Mouse.: Eun youn Cho, Yeon Lim Suh, Je Geun Chi; Korean J Pathol. 1999;33(8):570-580.

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Abstract PDF: We have studied morphologic characteristics and apoptosis on the fetal brain of the trisomy 16 mouse, a model for human trisomy 21 syndrome. This study was based on serial sections of the whole brain from a sample of sixteen trisomy 16 mice and forty-six age-matched control littermates from embryonic day (ED) 12 to ED 18. Trisomy 16 brains showed a reduction of telencephalic size and abnormal cortical development. At ED 13 trisomy 16 and control brains appeared similar. By ED 14 difference in the cortical thickness and telencephalic growth became evident, and by ED 16 a marked size difference had developed between the trisomy 16 and control brains. By ED 18, however, the thickness of the trisomy 16 cortex had increased considerably and was not significantly different with respect to the thickness and cross-sectional areas of the pallium and its constituent cortical layers. The cell density of the trisomy 16 cortex had persistently decreased before ED 17, when the cell density of control and trisomy 16 corteces was similar within each layer. At ED 18 cell density of trisomy 16 cortex in each layer increased. There was inverse relationship between a number of TUNEL positive apoptotic cells and cell density in the trisomy 16 brains. Our results suggest that developmental abnormalities of the trisomy 16 brain indicated developmental delay of the telencephalon growth, which may be caused by apoptosis rather than by a proliferation defect.

Analysis of Pulmonary Asbestos Body in Malignant Mesothelioma: A case report.: Hoon Kyu Oh, Jae Yoe Ro, Chul Jong Yoon, Je Geun Chi; Korean J Pathol. 1999;33(5):361-366.

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Abstract PDF: The association between occupational asbestos exposure and the subsequent development of malignant mesothelioma of pleura is well recognized. We analyzed an asbestos body by energy dispersive X-ray analyser in a case of malignant mesothelioma of pleura who had a history of asbestos exposure 30 years ago. In transmission electron microscope, the asbestos body was composed of a core of refractile thin asbestos fiber bundle and beaded masses of electron-dense iron and protein complex. The core fibers were analyzed as an amphibole type crocidolite fiber [(Na2Fe3Fe2(Si8O22)(OH)2] which composed of high content of silicon, iron and sodium.

Placental Metastais of Maternal Gastric Adenocarcinoma: A case report.: Hye Seung Lee, Young Ah Kim, Chong Jai Kim, Je Geun Chi; Korean J Pathol. 1999;33(3):214-216.

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Abstract PDF: Metastasis of a maternal neoplasm to the products of conception is extremely rare. About 50% of the reported cases were not examined grossly or had no grossly visible tumor deposit. A case of placental micrometastasis of gastric adenocarcinoma in a 28-year-old woman is presented. Artificial termination was performed in 22 weeks of gestation and a female fetus weighing 440 gm was delivered. The placenta weighed 220 gm and was grossly normal. Microscopic examination revealed a small number of micrometastasis scattered in the intervillous space.

Plastination: An Improved Method for Preservation of Pathology Specimens.: Chong Woo Yoo, Min Ho Choo, Sa Sun Cho, Sang Kook Lee, Je Geun Chi, Woo Ho Kim; Korean J Pathol. 1998;32(7):531-534.

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Abstract: The gross tissue specimens are a valuable aid to the teaching of pathology and anatomy. However, traditional methods for storage and handling of them are discouragingly difficult and, recently, minimal surgical resections as well as preoperative interventions make it more difficult to have instructive gross specimens. Plastination is a process of tissue preservation by impregnation with silicone polymers or epoxy resins. The process in our study involves dehydration by cryosubstitution in aceton, defatting, forced impregnation of silicon polymer in a vacuum, curing and finishing. We submitted 40 surgically resected specimens to plastination. The resulting specimens are odorless, relatively dry, durable, life-like, non-hazardous, maintenance-free, and do not deteriorate with time. Plastinated specimens are a useful adjunct to the teaching of pathology, particularly suited for use in small groups, and appropriate method of tissue preservation. They are much preferred to wet preparation and conventional pots by both students and teachers owing to their accessibility, superior illustrative powers, and comparative ease of interpretation.

Spermatic Cord Sarcoma: Two cases report.: Han Seong Kim, Je Geun Chi; Korean J Pathol. 1998;32(7):546-548.

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Abstract: Present study describes two rare spermatic cord sarcomas. The first case is leiomyosarcoma of a 56-year-old man with 3-years' history of slowly growing hard mass in the right inguinal area, measuring 8x6x5 cm. The second case is fibrosarcoma of a 39-year-old man with 3x2 cm painless right inguinal mass. Both cases underwent radical excision of mass and orchiectomy. Clinico-pathologic characteristics of spermatic cord sarcoma are discussed with literature review.

The Current Practice of the Autopsy Services and the Autopsy Records at the Seoul National University Hospital.: Jeong Wook Seo, Yoon Sung Lee, Je Geun Chi, Ghee Young Choe, Soong Deok Lee, Chong Jai Kim, In Ae Park, Woo Ho Kim, Ja June Jang, Chul Woo Kim, Seong Hoe Park, Jung Bin Lee, Hyun Soon Lee, Yong Il Kim, Eui Keun Ham, Sang Kook Lee; Korean J Pathol. 1998;32(6):453-459.

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Abstract: This study outlines the current status of the autopsy practice and the medical records for autopsies at the Department of Pathology, Seoul National University Hospital. Total number of autopsy cases from 1954 to 1995 was 3,131. Adults aged over 17 were 371 cases and children were 2,515 cases. The demographic data in 245 cases was not available. The number of adult autopsies and its proportion among total number of autopsies during 10-year periods decreased from 144 cases (40%) during the 10-year-period from 1956 to 52 cases (3%) during the 10-year-period from 1986. The number of children cases during the same period groups increased slightly from 210 cases (58%) to 393 cases (25%). But the number of fetal cases increased rapidly from 7 cases (2%) to 1,146 cases (72%). Among fetal autopsies the proportion of fetuses died earlier than 24 weeks of gestation increased and this figure exceeds that of fetuses that died later than 24 weeks of gestation from 1992. Forty percent of the cases were submitted from the clinical departments of the Seoul National University Hospital but the remainders were referred from 73 hospitals. Final autopsy diagnoses were analysed according to the Korean Standard Classification of Disease (KCD)-3 coding system and by searching key words for all cases. Common diagnoses as coded among cases from 1990 were P9, P0, P2, Q2 and Q0. Common diseases by key words for adult cases were liver disease, tuberculosis and pneumonia. Common diseases for children cases were pneumonia, hyaline membrane disease, meningitis and tuberculosis. Through this study we could show the importance of autopsy services for fetuses. We could also establish a regular registration system for autopsies at general hospitals.

Sarcomatoid Renal Cell Carcinoma; Special Reference to its Distinction from Carcinosarcoma.: Kee Taek Jang, Yeon Mee Kim, Je Geun Chi; Korean J Pathol. 1998;32(5):378-381.

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Abstract: Sarcomatoid renal cell carcinoma is an uncommon tumor that has to be distinguished from renal carcinosarcoma. We have described three cases of sarcomatoid renal cell carcinoma showing different clinical and light microscopic features. An ultrastructural study of the tumor cells from the sarcomatoid area revealed frequent desmosomal junction, confirming the epithelial nature of the neoplasm. All three cases showed an aggressive clinical course and tended to invade adjacent organs or tissues. We believe that an histological and immunohistochemical examination in conjunction with an electron microscopic examination are necessary to diagnose sarcomatoid renal cell carcinoma.

Prenatal Development of Sebaceous Gland: Morphologic and Morphometric Observation.: Im Joong Yoon, Je Geun Chi, Kye Yong Song; Korean J Pathol. 1998;32(4):273-282.

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Abstract PDF: This study was conducted to illustrate the histological and morphometric features of the sebaceous gland of human fetal skin. For this purpose, we studied 12 human embryos and 60 fetuses from the 4 th to 38 th week of gestation. In each case, we sampled eight different areas of skin, i.e., scalp, forehead, face, chest, abdomen, back, extremity, and palm and sole. Through routine tissue processing, hematoxylin and eosin preparations were made for morphology and morphometric analysis. The sebaceous gland anlagen is noted in the face and scalp by the 14th week of gestation, being subsequently generalized in other parts of the body, namely by 16th week of gestation. The lobation of the sebaceous gland subsequently differentiated into multilobular appearance in the face and scalp by the 17th week of gestation and in the chest and abdomen by the 26th week of gestation. The sebaceous ducts were seen by the 21th week of gestation in face and scalp, and in the chest and abdomen by the 27th week of gestation. In morphometric observation, the number and diameter of sebaceous gland were reached its peak during the 21st to 24th week of gestation, and then decreased gradually until it became constant in later days of the gestational period. In general, cephalic portion of the body had more sebaceous glands and also was larger in diameter. This difference became negligible as fetuses reached the term.

Cystic Hygroma of the Neck Pathologic study of 26 autopsy cases.: Yeon Lim Suh, Je Geun Chi; Korean J Pathol. 1997;31(12):1256-1263.

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Abstract PDF: Cystic hygroma is a congenital malformation of the lymphatic system appearing single or multiloculated fluid-filled cavities, most often around the neck. They often progress to hydrops and cause fetal death, and frequently associated with chromosomal abnormalities and other congenital malformations. The purpose of our study is to delineate the nature of cystic hygroma and determine the relationship between cystic hygroma and associated anomalies including fetal hydrops. We used data from 26 cases of cervical cystic hygroma in autopsy files of SNU Children's Hospital. Most of cystic hygroma were found in stillborn or premature infants. The fetal cases had been dead for a quite a long period since there was discrepancy between the true gestational age and the developmental age estimated from the body length. Of 26 fetuses only 2 were studied chromosomally and both of them showed 45X. Of 26 cystic hygromas 23 occurred in the posterior neck and 3 in the anterior neck. They ranged from 2.5 to 14 cm (mean: 7.9 cm). The cystic hygroma of the posterior neck consisted of two symmetric sacs on both sides and in the nape and extended to the occipital region. The cystic hygromas of the anterior neck were unilateral or bilateral, and multiloculated and extended into the adjacent cheek. Cystic hygromas of posterior neck were always associated with hydrops, while no recognizable hydrops was found in cystic hygromas of anterior neck. The cystic hygromas were larger in patients with severe hydrops than in patients with less severe hydrops. Associated abnormalities, found in 88%, included hydrops fetalis(88%), growth retardation(80%), cardiovascular anomalies(27%), horseshoe kidney(23%), skeletal anomalies(12%) and hypoxic changes(31%) in visceral organs. In summary, when a hygroma is detected during fetal life, careful sonographic examination for associated congenital anomalies, fetal karyotyping and consideration of artificial abortion are indicated.

Multilocular Cystic Renal Cell Carcinoma.: Myoung Jin Ju, Kee Tac Jang, Je Geun Chi; Korean J Pathol. 1997;31(11):1240-1243.

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Abstract: Multilocular cystic renal cell carcinoma is a distinct subtype of renal cell carcinoma with its pathological characteristics and good prognosis. Multilocular renal cysts and renal cell carcinoma with cystic change are important differential diagnoses. We report a case of multilocular cystic renal cell carcinoma in a 37-year-old woman who came to the hospital because of the right renal mass. The removed right kidney showed a 6x4 cm well defined cystic mass in the lower pole. On cut section there were multiple cavities in the mass, filled with serosanguineous fluid and focal yellowish solid area. Microscopically, these cysts were lined by a single layer of flat or cuboidal cells consisted of clear cytoplasm with small central nuclei. In some portions of the tumor, the clear neoplastic cells formed sheets within the septa or walls of the cysts.

Cystic Struma Ovarii Mimicking Adenomatous Goiter of the Thyroid.: Kee Taek Jang, Je Geun Chi; Korean J Pathol. 1997;31(7):692-694.

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Abstract PDF: Struma ovarii, the most common monodennal teratoma of the ovary, causes diverse problems in differential diagnosis. The literature on the pathology of struma ovarii has focused principally on the problem of formulating criteria of malignancy. In contrast, unusual gross and microscopic features of struma ovarii and its resultant problems in differential diagnosis have received relatively little attention. We report an ovarian teratoma which was almost entirely cystic, causing the diagnosis of struma to be overlooked. The removed ovarian tumor showed all the features of adenomatous goiter of the thyroid gland. The lining epithelium of the cysts was frequently flattened, and the follicles in the cyst wall were few and atrophic. The patient was a 58-year-old woman who was found to have an ovarian tumor by routine monographic examination

Clinicopathological Analysis on the 104 Cases of Malignant Melanoma.: Kye Yong Song, Kyeong Cheon Jung, Kwang Hyun Cho, Je Geun Chi, Eui Geun Ham; Korean J Pathol. 1997;31(6):566-573.

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Abstract PDF: The cliniopathological analysis was done on the 104 cases of malignant melanoma diagnosed at the Seoul National University Hospital (SNUH) from 1984 to 1993. The basic clinical data and the pathological items were based on the New Mexico Melanoma Registry Worksheet. The results were as follows. The male to female ratio was 1 : 0.79. Primary cutaneous melanoma was more common in the male (M : F=1 : 0.56) but primary extracutaneous melanoma with slight female dominancy (M : F=1 : 1.25). The peak age was the 6th decade in both cutaneous and extracutaneous malignant melanoma. In 66% (35 cases) of primary cutaneous malignant melanoma, the primary site was located in the acral area (including cases of acral lentiginous and nodular type), of which 63% (41% of total cutaneous melanoma) was acral lentiginous type. Major components of tumor cells were epithelioid. Clark's level of tumor was III or more at the time of the first visit in the majority of the cases (85%). The incidence rate of extracutaneous melanoma was 34.6% (36 cases) among the primary melanoma, and the eyeball (17.3%) was the most prevalent organ. All these features suggest that the racial difference between the Korean and the Caucasian is evident and also that etiologic role of sun damage is not quite marked in the Korean. We also suggest that an early detection program is very important to cure this malignant tumor.

Achondrogenesis Type 2: An autopsy case.: Joon Mee Kim, Young Chae Chu, Soo Kee Min, Hee Jeung Cha, Je Geun Chi; Korean J Pathol. 1997;31(5):482-488.

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Abstract PDF: Achondrogenesis type 2 is a lethal form of congenital skeletal dysplasia characterized by severe short-limbed dwarfism, decreased vertebral ossification and normal ossification of the skull. We report an autopsy case of achondrogenesis type 2 in a female fetus terminated at 29 weeks of gestation. External morphology revealed a relatively large head, short upper and lower extremities, short neck, and distended abdomen. The x-ray finding showed normal calvarial ossification, hypoplastic ilium and unossified ischium, and metaphyseal flares of the femur and tibia. Histologically, chondrocytes were large and irregular with increased vascularity.

Intrapulmonary Cystic Lymphangioma.: Mi Yeong Jeon, Je Geun Chi; Korean J Pathol. 1997;31(5):492-494.

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Abstract PDF: Solitary intrapulmonary cystic lymphangioma in newborn or infant is an extremely rare disease. We describe a case of solitary intrapulmonary cystic lymphangioma in a 4-month-old boy with dyspnea and tachypnea. It was in the left lower lobe and type 1 congenital cystic adenomatoid malformation was suspected radiologically. The resected cyst was unilocular with a thin wall, and was 9.5cm in size. Histologically, the cyst was lined by flattened endothelial cells supported by a minimal fibrous stroma.

Congenital Cystic Disease of the Kidney overview and a classification.: Mee Joo, Yeon Mee Kim, Chong Jai Kim, Yeon Lim Suh, Jeong Wook Seo, Je Geun Chi; Korean J Pathol. 1997;31(3):233-243.

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Abstract PDF: The congenital renal cystic disease encompasses a complex group of pathologic and clinical entities. We retrospectively reviewed 42 cases of congenital renal cystic lesions classified into four Potter types in a series of 2,063 consecutive autopsies from 1981 to 1996. According to our study based on morphologic, clinical, genetic features and associated anomalies, type I and III are relatively compatible with Potter's original definition. However, it was reasonable that type II and IV are classified to the same group because of: 1) very similar histologic findings representing dysplastic kidney, 2) many associated anomalies, 3) no evidence of inheritance, and 4) presence of a combined type. Syndrome associated cysts, such as Meckel-Gruber syndrome, were also separately classified. If the dysplastic evidence was insufficient for diagnosis to the dysplastic kidney in type II and IV, then these cases would be better classified into a cystic disease associated with congenital hydronephrosis. We propose a classification of the congenital cystic disease of the kidney to be: 1) dysplastic kidney, 2) cystic disease associated with congenital hydronephrosis, 3) polycystic kidney, and 4) syndromic cystic disease.

Intraabdominal Heterotopic Thymus: Report of an autopsy case.: Hye Seung Han, Je Geun Chi; Korean J Pathol. 1996;30(11):1057-1059.

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Abstract PDF: Ectopic thymus results from the aberrant migration of thymic tissue and is mostly present in the mediastinum, the base of the skull, the tracheal bifurcation and the cervical region. We report the first case of intraabdominal heterotopic thymus incidentally detected and attached to the liver without associated anomalies. This fetus was sent to the Department without any clinical information. The fetus was small for gestational age, but had no external abnormalities. Each organ showed normal development except for the liver. The liver weighed 6 gm(normal 17.064+/-4.143 gm). Gray white heterotopic thymus was attached to the superior surface of the liver in the subdiaphragmatic area. It measured 1.1x0.6x0.5 cm. There was no diaphragmatic defect. The cervical thymic tissue near the thyroid was small and measured 0.2 gm(normal 0.927+/-0.485 gm). There was no thymic tissue in the anterior superior mediastinum. The histologic features of the heterotopic thymus were identical to the orthotopic thymus showing features appropriate for the gestational age. The origin of this subdiaphragmatic heterotopic thymus is speculated.

Application of the Revised Case Matrix Format to Tutorial in Pathology Teaching: An Interim Approach toward Problem-Based Learning under Traditional Curricular Structure.: Yong Il Kim, Chong Jai Kim, Gee Young Kim, Chul Woo Kim, Woo Ho Kim, Ja June Jang, Je Geun Chi, Gyeong Hoon Kang, Myeong Cherl Kook, Jung Sun Kim, Tae Sook Kim, Gee Young Kwon, So Dug Lim; Korean J Pathol. 1996;30(8):570-661.

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Abstract: This paper describes a student-centered case study program concerning the tumor pathology course for first year students in medical school under the traditional curricular structure. A traditional, discipline-oriented, lecture-laboratory approach was partly modified by introducing a tutuorial session using a modified case matrix format during the laboratory hours without altering the general scheme of the existing system. Small group tutorial sessions were set with the development of learning objectives emphasizing clinicopathologic reasoning and early exposure to future practical presentation which was followed by the large class session; each tutorial was supplied with a short clinical history, gross kodachrome slides, and microslides. The session for problem identification was replaced by proving a series of instructor-designed questions for both pathology and interdisciplinary correlation during which pedagogical implication was stressed the most. Student's active participation, development of self learning skill and vigorous teaching-learning process among students, and motivation/relevance for forthcoming pathology study were among the benefits conferred by this modification. We conclude that this approach is an interim step to meet the advantages of problem-based learning even in a traditional curricular structure.

Infantile Myofibromatosis(Congenital Generalized Fibromatosis): Associated with multiple congenital malformations and basaloid follicular hamartomas in the skin.: Eun Sook Nam, Yoo Hun Kim, Han Kyeom Kim, Insun Kim, Je Geun Chi; Korean J Pathol. 1995;29(6):776-782.

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Abstract PDF: Infantile myofibromatosis with systemic involvement is a very rare disease and is characterized by numerous nodules composed of spindle cells of a myofibroblastic nature. There are often disseminated throughout the subcutis, muscle, skeleton and viscera. We report an autopsy case of infantile myofibromatosis in a stillborn female fetus of 32 weeks of gestation. The nodules, Imm to 2 cm, were found over the whole body and viscera. The involved viscera were the heart, tongue, esophagus, gastrointestinal tract, portal areas of the liver, spleen anc pancreas. There were also associated malformations, viz., frontal meningoencephalocele, flexion defer-mities, syndactyly, cleft palate, agenesis of corpus callosum, pachygyria, diaphragmatic hemia, renal hypoplasia, etc. Multiple basaloid follicular hamartomas of the skin were noted on the face and extremeties. There are no previous reports in the literature of infantile myofibromatosis in conjunction with the above skin lesion and congenital malformations.

Holoprosencephaly Associated with 63, XXY Karyotype: An autopsy report.: Ji Hwa Kim, Ik Su Kim, Je Geun Chi; Korean J Pathol. 1995;29(1):106-109.

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Abstract PDF: Holoprosencephaly, a grave malformation during cleavage phase of brain development, occurs in association with a variety of clinical syndrome including chromosomal aberration. Among chromosomal anomalies trisomy syndromes, particularly trisomy 18, are often associated with holoprosencephaly. Triploidy with holoprosencephaly had also been described. We report an autopsy case of incomplete triploidy with abnormal sex chromosome, i.e., 63, XXY. Our case showed a marked intrauterine growth retardation, and postmortem examination revealed alobar holoprosencephaly, hypotelorism, bilateral cleft palates and lips, flat nose, microstomia, lowset ears, congenital heart disease and cystic kidney. The brain was microcephalic 5 x 6 cm and was of pancake shape. there was a large dorsal cyst. Olfactory tracts and bulbs were absent. The brain surface was smooth, and only suggestive hippocampal fissure was noted. The basal ganglia and thalami were fused in midline and the aqueductal origin was exposed. The brain stem and cerebellum were unremarkable. Repeated karyotypings revealed 63,XXY consistently. All 21 chromosomes showed trisomy except for D group. The sex chromosome was XXY, and the genital tract and gonad were those of female.

Ultrastructural Observation on Maturation Process of Cytomegalovirus in Human Cells.: Chul Jong Yoon, Je Geun Chi; Korean J Pathol. 1994;28(5):478-484.

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Abstract PDF: Cytomegalovirus(CMV) infection can be diagnosed by finding characteristic intranuclear inclusion body and enlargement of the cell size congenital CMV infection can be associated with various types of anomalies seen in different gestational age. These anomalies are probable due to direct virus infection of the parenchymal cell m early gestation. Based on four autopsy cases of congenital CMV infection we have studied maturation process of virus particles in parenchymal cells, with special reference to me mode of replication and transmission. Virus particles in CMV-infected cells in brain and kidney showed nucleocapsids with characteristic concentric core, that were enclosed around fibrillar network in nucleus. During replication process virions showed various morphogenic mutation that was rather consistent in different tissues and individuals. There were virions without core or with eccentric core. Occasional cores were divided into 2~5 fragments. The virus particles reached the cytoplasm through the nuclear membrane, and here the virions increased twice in size. After virions were fully matured in the cytop1asm. they showed exocytosis phenomenon through the cellular membrane to reach extracellular portion.

A Study of Umbilical Cord Length According to the Gestational Age.: Eun Kyung Kim, Je Geun Chi; Korean J Pathol. 1994;28(5):511-513.

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Abstract PDF: The umbilical cord length may be a reliable indicator of fetal activity during gestation because it grows in response to tensile forces related to fetal movement. But there has been little attention to normal range of the umbilical cord length. We analyzed the umbilical cord length of 2342 cases de1ivered in Seoul National University Hospital to determine mean values according to the gestational age. The umbilical cord length increased linearly from 15.5cm of 13 week to 50.6 cm of 44 week. After 42 week, the growth was nearly stopped. There was no difference by fetal sex. The length of umbilical cord was variable even within same gestational age.

Superficial Angiomyxoma: A case report.: Ji Hwa Kim, Joo Ryung Huh, Je Geun Chi; Korean J Pathol. 1994;28(5):544-546.

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Abstract PDF: Superficial angiomyxoma is a comparatively rare dermal and subcutaneous tumor. We report a case of superficial angiomyxoma of the thumb in view of its rarity and typical light and electronmicroscopic features. The patient was a 46-year-old male. who presented with an asymptomatic, slowly enlarging mass that developed in the left thumb over the 5 years. He had a history of trauma and electric burn in the same area 20~30 years ago. Simple X-ray and magnetic resonance imaging revealed 35x30mm, mass with destruction of distal phalangeal bone. On operation, the lesion was moderately well circumscribed and soft with lobulated nodules that elevated the overlying skin and destroyed the underlying bone. The cut surface of the mass was glistening and slimy. The mass was whitish gray and lobulated. Bony involvement was not present. Microscopically, the tumor was composed of stellated and spindle shaped stromal cells which were scattered throughout myxoid ground substance. Neither nuclear hyperchromasia nor plemorphisam was present. Small to medium sized thin walled blood vessels were scattered. There was a scanty infiltrate of inflammatory cells. The S-100 protein immunostaining was negative in tumor cells. On electron microscopy, the cytoplasm of the stromal cells contained well developed rough ednoplasmic reticulums and other features that indicated differentiation toward fibroblasts.

Parapelvic Renal Cyst (Pericalyceal Lymphangiectasis): A case report.: Weon Seo Park, Je Geun Chi; Korean J Pathol. 1994;28(2):210-212.

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Abstract PDF: Parapelvic renal cyst, also designated as pericalyceal lymphangiectasis, is an unusual lesion that is usually brought to light during surgery for ureteropelvic junction obstruction or recurrent pyelonephritis. Grossly, the renal pelvis is enveloped by a multilocular cystic mass filled with clear fluid. This lesion is confined to the peripelvic tissues and does not extend into the parenchyma, which, however, may show the effects of hydronephrosis or pyelonephritis. A 50-year-old man presented with hydronephrosis. An ultrasonography revealed hydronephro-sis of the left kidney. Intravenous pyelography and DMSA ("Tc-Dimercaptosuccinic acid) scan showed nonfunctioning kidney of the same side. Simple left nephrectomy was done. The renal pelvis was mildly dilated and a cyst was found buldging into the renal pelvis. The content was watery clear and the cyst was not connected to the renal pelvis or calyces. The cyst was round unilocular and lined by attenuated single layer of endothelial cells. The endothelial cells showed no reactivity to factor-VIII related antigen. With these findings, we concluded that this cystic lesion is basically lymphatic cyst and hydronephrosis was caused by the compression of pelvic out-flow of the kidney.

Development of Endocrine Cells of Human Pancreases: A Morphologic and Immunohistochemical Study.: Jung Hee Cho, Je Geun Chi; Korean J Pathol. 1989;23(1):43-50.

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Abstract PDF: Pancreases from 123 human embryos and fetuses ranging from 3 weeks to 40 weeks of gestation age were studied. Thirty four cases were examined by immunohistochemical preparations to investigate the temporal development of the pancreatic islet particularly with reference of its origin, time of appearance and interrelation of various types of islet cells. Following results were made. 1) The endocrine cells and the acinar cells both originated from the primitive pancreatic duct cells. 2) Alpha, beta and delta cells began to appear almost simultaneously at 10 weeks og gestation. A, B and D cells, in decreasing order of frequency, were all found in the entire areas of the pancreas. 3) Four types of fetal islets i.e., preimtive, "homologous", bipolar and mantle, could be recognized during development. The latter 3 types first appeared simultaneously at 17 weeks of gestation. They continued to increase in sized and number throughout the fetal life and constituted permanent islets. 4) Two types of islet cells could be distinguished with routine H&E staining after the second trimester. 5) The size of fetal pancreatic islets were rapidly increased between early (64 micrometer) and mid-term (113 micrometer) (p<0.05). 6) The primitive islets were composed of 37.3% of alpha cells, 41.3% of beta cells and 13.4% of delta cells. At mid-term the mantle islets were composed of 36.4% of alpha cell, 42.7% of beta cell and 25.6% of delta cell. At term beta cell was higher value (52.6%) than alpha cell (29.3%) and delta cell (17.6%) (p<0.05).

Meckel-Gruber Syndrome: An autopsy case.: Soong Deok Lee, Chul Woo Kim, Je Geun Chi; Korean J Pathol. 1988;22(4):505-509.

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Abstract PDF: We report an autopsy of a male fetus that showed multiple congenital anomalies that could best be designated as Meckel-Gruber syndrome. The fetus was born dead at the gestational age of 38 weeks. His parents denied any history of congenital malformation. And the parity of the mother was 0-0-0-0, but she had the past history of receiving herb medication for common cold. The congenital anomalies found in this case consited of occipital meningoencephalocele, midline cleft palate, bifid epiglottis, hepatic fibrosis, choledochal cyst, bilateral polycystic kidneys, postaxial polydactyly of both hands and feet, aplasia of the left testis, secundum type atrial septal defect and patent ductus arterious. This malformation syndrome is rare and lethal. The prenatal diagnosis should be made by ultrasound study or analysis of the amniotic fluid for alpha-feto protein during intrauterine period. The kidneys showed Potter type III cystic change and there was a characteristic hepatic fibrosis.

Mitral Atresia Associated with Corrected Transposition of Great Arteries.: Dong Heon Yoon, Jeong Wook Seo, Je Geun Chi, Yong Soo Yoon, Jeong Yeon Choi, Yong Jin Kim, In Won Kim; Korean J Pathol. 1988;22(3):295-300.

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Abstract PDF: A case of congenital absence of right atriovntricular (A-V) connection of heart is reported. Patient was 81 day old male infant with chief complaints of dyspnea and irritability. Clinical evaluation revealed increased pulmonary vascularity on chest x-ray, absence of right A-V connection, regurgitation of left A-V valve, right-sided ventricular hypoplasia and L-TGA. Clinical assessment of the case was tricupsid atresia with LTGA and mitral regurgitation. Pulmonary artery banlding and artial septectomy was performed. Parenteral alimentation through the femoral veins resulted in obstruction of IVC and subsequent multiorgan failure. The autopsy findings of the heart were corrected transposition of great arteries with associated anomallies of right-sided mitral atresia, Ebstein's malformation of left-sided tricuspid valve, ventricular septal defect, muscular hypertrophy of right-sided left ventricle with luminal obliteration. Long segment of IVC was completely occluded due to occlusive thrombi with fungal infection. Bilateral kidneys were infarcted and azygos vein was markedly engorged. Microscopic examination revealed candidal colonization in the inferior vena cava and septic embolzation in brain.

Porencephaly: An Autopsy Case Report.: In Sook Kim, Jin Hee Shon, Hyo Sook Park, Je Geun Chi; Korean J Pathol. 1988;22(2):199-203.

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Abstract PDF: Porencephaly is a rare congenital anomaly characterized by a cavitary hole extending from the cerebral mantle to the ventricle of the brain and covered by leptomeningeal membrane. It is now generally believed that the porencephaly represents a fetal or neonatal destructive process of the neural tissue. Authors experienced an autopsy case of bilateral porencephaly in a 35-day-old Korean male infant who died of sepsis. The brain weighed 150 gms and morphologically well formed except for two large symmetric defects at the fronto-parietal region. These defects were characterized by cleft-like shape, covering the entire cerebral mantle with resultant direct communication between ventricular cavity and leptomeninges. Thin leptomeningeal trabeculae were covering the cavity. There was a smooth transition between ependyma and roof of the defects. There are focal, microscopic cerebral infarct and abscess without connection with the cavitary lesion. The remaining central nervous system was unremarkable.

Postirradiation Extraskeletal Osteosarcoma (A case associated with aggressive fibromatosis).: Hy Min Kim, Je Geun Chi, Yong Il Kim, Eui Keun Ham; Korean J Pathol. 1987;21(2):98-101.

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Abstract PDF: A case of postirradiation extraskeletal osteosarcoma with aggressive fibromatosis of the overlying soft tissue of radiation field is reported in a 57 year old house wife who was treated with operation and radiation therapy for cervix carcinoma of the uterus 23 years ago. The overlying aggressive fibromatosis showed characteristic radiation angiitis and atrophic vascular changes such as hyaline degeneration and obliteration of the capillaries which were highly campatible with radiation changes. She also had multiple osteogenic sarcoma in pelvic cavity, occurring in the mesentery bed. As for the histogenesis in this case, we thought the possiblity that fibroblasts went through a process of differentiation into osteoblasts that were responsible for bone formation in the process of malignant change of the aggressive fibromatosis.

Ragocytes in Synovial Fluid.: Sang Yoon Kim, Je Geun Chi; Korean J Pathol. 1987;21(1):54-56.

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Abstract PDF: Exfoliative cytology of synovial fluid is less stressed in medical practice, but it can be a very useful tool for the differential diagnosis of various joint diseases. This report describes a case of juvenile rheumatoid arthritls in a 7 year old girl, who showed characteristic ragocytes in joint fluid. Synovial biopsy specimen confirmed the diagnosis of rheumatoid arthritis.

Congenital Cytomegalovirus Infection Associated with Massive Periventricular Calcification and Probably in Burnt out Phase: An autopsy case report.: Eun Sil Yu, Je Geun Chi; Korean J Pathol. 1986;20(4):503-508.

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Abstract PDF: We report an autopsy case of congenital cytomegalic inclusion disease that was associated with massive periventricular calcification and hydrocephalus. The male boy was bron by cesarian section at 38 weeks of gestational age to a 28 year old mother and was dead two hours after delivery because of respiratory difficulty. Radiologic findings showed characteristic linear periventricular calcification, being associated with marked dilatation of the lateral ventricles. At autopsy, the brain parenchyme became 0.4 cm in average thickness due to obstructive hydrocephalus at aqueductal level. The inner surface of the lateral ventricle showed grayish white granular appearance that could correspond to the calcification seen on plain skull X-ray films. Although active ependymitis, destruction of the brain parenchyma with dystrophic calcification and gliosis were noted, there was no intranuclear inclusion. After scrutinizing many sections of various organs and tissue, we could be able to demonstrate a few inclusion bodies, highly suggestive of cytomegalic inclusion disease. It was discussed that this case might suggest that intranuclear inclusions in cytomegalovirus infection could by very difficult to find particularly when the infection is in inactive phase despite the presence of tissue necrosis and calcification of the brain.

Male Pseudohermaphroditism Associated with Bochdalek Diaphragmatic Hernia: An autopsy case report.: Eun Sil Yu, Je Geun Chi, Sang Sook Lee; Korean J Pathol. 1986;20(4):470-474.

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Abstract PDF: An autopsy case of male pseudohermaphrodite associated with Bochdalek diaphragmatic hernia is reported. This newborn infant showed a large clitoris and hypospadic urethra which was the only opening in the perineum except for the anus. There were urethrovaginal fistula and uterus didelphys. The adrenals were slightly larger than normal, but microscopically did not show any features of cortical hyperplasia. Well formed testes were found and were histologically unremarkable. In addition, Bochdalek type of diaphragmatic hernia was present, associated with severe left lung hypoplasia and massively herniated abdominal organs into the chest cavity, shifting the mediastinum considerably and eventually led to death in a few minutes after birth. The pathogenesis of genital anomaly and diaphragmatic hernia is briefly discussed and it is suggested that this type of genital abnormality might be due to defect of testicular M llerian inhibitor factor and can be categorized as incomplete male pseudohermaphroditism.

Morphological Changes of Coronary Arteries in Childhood.: Jeong Wook Seo, Je Geun Chi, Chang Yee Hong; Korean J Pathol. 1986;20(3):305-312.

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Abstract PDF: The coronary arteries of young individuals are histologically studied. Fourteen cases in pediatric age group and three adult hearts were used. No case had clinical and pathological evidences of heart disease. Inner circumference, thickness of tunicae intima, media and adventitia were measured at eight different sites of coronary arteries. The thickness of tunica media was used as a standard scale of cardiac growth, and the heart weight, body weight, height and age were compared with the medial thickness. The morphological changes were assessed in five groups by the heart weights. Group I ( less than 10 gm) showed single endothelial lining with cytoplasmic vacuolization or endothelial denudation. Group II (more than 10 but less than 20 gm) consisted of full term babies and showed first stigma of focal intimal thickening and intimal collagen fibers. Diffuse intimal thickening more than 1/1 of medial thickness was first seen in a case with 46 gm of heart weight. Elastic fiber was not seen in internal elastic laminae of groups I and II. Fragmentation of internal elastic lamina and smooth muscle proliferation as a form of musculoelastic layer were the major findings of intimal thickening in childhood and no case showed complicated atherosclerotic lesions.

Congenital Cystic Disease of the Lung.: Jin Hee Sohn, Je Geun Chi; Korean J Pathol. 1986;20(2):215-221.

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Abstract PDF: Congenital cyst of the lung is a type of rare pulmonary disease. This lesion was initially introduced by Morgagni in 1769. Thereafter many other cases were reported. Etiology or developemental pathogenesis of this lesion is not certain, but abnormal developement of embryonic lung bud during the embryonal period is highly suspected. This lesion is two times more frequently located at the left lung, but both sides of the lung may be involved. This lesion is largely asymptomatic and found incidentally but can be evoked respiratory symptoms and also can be died due to only this lesion. So accurate diagnosis and treatment in the early period are very important. Therefore, 32 cases of congenital cyst of the lung reported at the department of pathology, seoul national university hospital from 1. 1986 to 12. 1984 were reviewed and classified with clinical, gross and microscopic findings based on the Buntain's classification. Among 32 cases of congenital cyst of the lung, 16 cases were bronchogenic cysts and were largest in number, 8 cases were pulmonary sequestration, 6 cases were congenital cystic adenomatoid malformation (CCAM) and 2 cases were pulmonary emphysema. In cases of bronchogenic cyst, involved age was variable from 7 months to 51 years and large cases were asymptomatic. Grossly, 15 cases were solitary cyst and only one case was multiple. Size was also variable from 3 cm to 11.5 cm. Microscopically, cyst wall was lined by pseudostratified ciliated columnar epithelium with gobet cells, mucous secreting glands, smooth muscle fibers and fibrous interstitial tissue. Three cases were also exhibit cartilage at the wall. In cases of CCAM, there were involved below the 7 months old boys and girls. Four cases were confirmed at the autopsy, other 2 cases were confirmed at the surgical specimens which were found incidentally or due to generalized cyanosis. Microscopic findings were similar in all cases showing relatively well demarcated multiple small cysts with adenomatous proliferation. Lining epithelial cells were tall columnar, pseudostratified ciliated columnar epithelium with occasional mucous secretion. Stroma also exhibit adenomatous proliferation lined by simple columnar or cuboidal epithelium. In cases of pulmonary sequestration, 7 cases were intrapulmonary, other one case was extrapulmonary sequestration. In five cases, systemic large vessel were confirmed. Microscopically it was composed of irregularly dilated bronchiolar structures lined by pseudostratified ciliated columnar epithelium.

Fibrous Hamartoma of Infancy: Report of three cases.: Eun Hee Suh, Kyung Ja Cho, Geung Hwan Ahn, Je Geun Chi; Korean J Cytopathol. 1985;19(2):202-206.

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Abstract PDF: Fibrous hamartoma of infancy is a distinct clinicopathologic entity with unique microscopic findings and benign clinical course. This tumor is composed of intervening dense fibrocollagenous trabeculae, well defined mucoid areas and varying amounts of mature fat, which are arranged in organoid growth pattern. We report three typical cases of this tumor which were experienced during the recent two years at the Seoul National University Hospital. It is the first description on this tumor in Korean literature. Case 1 was a 10 month old boy who was admitted due to a mass in the right infra clavicular area for 6 months. The mass showed irregular and poorly circumscribed outer surface. Case 2 was a one month old girl who was presented with a diffuse ill defined hairy mass in the left buttock since birth. Case 3 was a 15 month old boy who was brought to the hospital due to well circumscribed scrotal mass fot 8 months. Microscopically all three cases showed very similar histological features. And all 3 cases are well after the removal of the tumors.

Epidermoid Cyst of Testis in Klinefelter's Syndrome: A case report.: Seong Sook Kim, Sang Yoon Kim, Geung Hwan Ahn, Je Geun Chi; Korean J Cytopathol. 1985;19(2):220-222.

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Abstract PDF: The epidermoid cyst of the testis is a rare benign lesion with a characteristic gross and microscopic appearances. This 25 year old male who had been previously diagnosed as Klinefelter's snydrome (47/XXY) had right orchiectomy due to hard testicular nodule for a presented malignant testicular tumor. Sectioning of the testis revealed a intraparenchy matous cystic lesion, 1.5 cm in diameter, filled with cheesy white material. Histologically, stratified squamous epithelium lined the cyst. The remaining testis showed advanced tubular sclerosis and Leydig cell hyperplasia. It is necessary to submit multiple sections to rule out other histologic elements in the cyst wall or the presence of a scar. Although epidermoid cyst occurring as a solitary testicullar nodule could be regarded as a stage in the development of a teratoma, they need to be distinguished from the complex differentiated teratomas because of a distinct difference in prognosis.

Microgliomatosis: A case report with literature review.: Hyung Sik Shin, Kye Sook Lee, Seong Hoe Park, Je Geun Chi; Korean J Cytopathol. 1985;19(1):112-118.

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Abstract PDF: In 1929, Bailey first described an intracranial sarcomatous tumor as a term of perithelial sarcoma. The term of microgliomatosis was introduced by Benedek and Juba, 1941. In recent period, malignant lymphoma was widely used rather than many other terms such as reticulum cell sarcoma, malignant reticulosis, etc. An autopsy case of microgliomatosis was presented. She was a 33-year-old woman with headache, ataxia, memory disturbance, defecation and micturition difficulty. She was relatively well until 3 months earlier before admission. She visited first St. Vincent Hospital due to memory disturbance, and a tumor was found in her left frontal lobe by CT scanning of her brain. She was transferred to Kang Nam Sacred Heart Hospital for further evaluation of the tumor mass. She ws given steroid therapy and somewhat improved in her symptoms. By follow-up CT scannings, the tumor could not be found. Her general conditions were progressively deteriorated and died on 85th day of her admission. Brain limited autopsy was performed. The external features of her brain were grossly unremarkable. Cut surfaces revealed multiple ill-defined grayish white masses, especially on deep white matter of left frontal lobe, left cingulate gyrus and white matter together with medial side of basal ganglia. The definite size was not able to be measured, but the largest one in left frontal lobe was about 2.5cm in diameter. Microscopically, the tumors have many characteristics of microgliomatosis, such as perivascular arrangement of tumor cells and concentric reticulin condensation. These microscopic features were seen not only in grossly visible masses but also in other areas, almost all cerebral hemispheres. Literature review on microgliomatosis and a case report were done.

Histological Observations on Human Thyroids: 100 cases analysis of embryos and fetuses.: Eun Hee Suh, Seong Hoe Park, Je Geun Chi; Korean J Cytopathol. 1985;19(1):27-36.

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Abstract PDF: To evaluate the morphogenesis of the human thyroid, a histologic study was made based on 100 normal thyroids of human embryos and fetuses ranging in age from 4 to 42 weeks of gestation. The embryos were serially sectioned and fetuses were examinated as an individual organ. 1) The first sign of thyroid primordium was the spherical proliferation of median ventral pharyngeal wall at the 4th week of development. 2) At the 6th week of gestation, the thyroid differentiated into two lobes that were connected by an isthmus, and was on the way of migration to the definite position from the foramen cecum. 3) The developing thyroid consisted of two cell cords, solid nests or interconnecting complex pattern until 14th week of gestation, when the entire portion of thyroid was replaced by follicles of variable size. 4) At the 9th week, the first follicle was recognizable at the periphery of the gland. 5) At the 14th week, follicles were partly filled with faintly eosinophilic colloid. 6) After the 18th week of gestation, lobulation of the thyroid parenchyme was a prominent feature. 7) After the 24th week, large follicles with rich colloid content are distributed through both superificial and deep portions. And after the 34th week, maturation reached the general pattern of adult thyroid. 8) The ability of thyroglobulin synthesis which was confirmed by PAP method, was first recognized at the 10th week of gestation.

Studies on Morphology and Fibrinolytic Activity of Ganglionic Eminence.: Hyun Sook Chi, Je Geun Chi; Korean J Cytopathol. 1985;19(1):1-12.

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Abstract PDF: Ganglionic eminence initially appears as a slight swelling in the floor of the cerebral vesicle during the 5th fetal week and attains maximum prominence late in the 4th fetal month; it then declines in relative size, and nearly disappears after birth. The ganglionic eminence constitutes a collection of the proliferating cells throughout most of span of gestation and supply neuroblasts and spongioblasts to basal ganglia and pulvinar region of thalamus and cerebral cortex. Nowadays intraventricular hemorrhage predominantly occurs in preterm infants of less than 32 weeks gestational age, and the intraventricular hemorrhage arises most frequently from rupture of a ganglionic eminence hemorrhage is equally frequent in both hemispheres and is associated with an extensive destruction of the capillary bed without arterial or venous rupture. Although fibrin thrombi are seen within veins in relation to ruptures at the capillary vein junction, the other study reveals little or no fibrin is to be seen within the ganglionic eminence hemorrhage presumably due to the high fibrinolytic activity within this region of the immature brain. Accordingly this study was planned to evaluate the ganglionic eminence of fetal brain in two aspects, i.e., morphological development of ganglionic eminence during gestation and functional maturation by measuring fibrinolytic activity of various portions of developing brains. To evaluate the development of ganglionic eminence a total of 97 brains of Korean fetuses of gestational ages ranging from 16 to 37 weeks, was studied; 62 for morphological study and 35 for functional study. The fetuses were products of therapeutic abortions, and were proved to be normal after complete examination of fetuses and placentas. The brains were removed as soon as possible after delivery, and were fixed in 10% formalin for 1 to 2 weeks before being examined. Representative blocks containing white matte around lateral ventricle, ganglionic eminence, caudate nucleus and thalamus on the serial coronal sections. Through routine histological procedure, slides were made and stained with hematoxylin and eosin for microscopical examination of the ganglionic eminence and striatum. The fibrionlytic activity of the tissue was measured by fibrin plate method of Astrup and Albrechtsen and the amount of lysis expressed as area/mg of wet tissues. As controls comparable aliquots of 2M potassium thiocyanate or saline alone had no fibrinolytic activity. To detect the in vivo fibrinolysis, fibrin and/or fibrinogen degradation product, staphylococcal clumping tests for the tissue extracts were performed. Following results were obtained. 1) The ganglionic eminence was well formed and located at the lateral side of terminal vein and over the caudate nucleus and protruded into the lateral ventricle. 2) The thickness of the ganglionic eminence is reached to maximum width by 20th week of gestation and is shown a progressive reduction till 30th week, and revealed sharp reduction after 31th week of gestation and became no longer recognizable after 37th week of gestation. 3) The ependymal layer was most thickened at 16~19th week of gestation, showing 6~8 layers with numerous mitoses and declined to 2~3 layers at 28~31th week of gestation and no more mitosis was found. 4) The distribution of capillary beds were most pronounced at 16~19th week of gestation and the permeation of the capillaries to the ependymal zone and decreased in number after 20th week of gestation. The medium sized, well developed veins were demonstrable at the junction of ganglionic eminence and caudate nucleus from 24th week of gestation. 5) The fibrinolytic activity of the choroid plexus and leptomeninges were significantly increased than the other areas(p<0.005) and there was no evidence of gestational changes. 6) The fibrinolytic activity of the ganglionic eminence was no more pronounced than those of cerebral cortex, periventricular white matter, cerebellum and spinal cord.

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