Journal of Pathology and Translational Medicine

Volume 18(2); January 1984

Etcs

Pathological Study on Wilms' Tumor: Jeong Wook Seo, Je Geun Chi, Sang Kook Lee, Hyo Seop Ahn; Korean J Pathol. 1984;18(2):113-121.

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Abstract: Twenty-nine Wilms' tumors of 144 resected renal neoplasms during the period 1968 ti 1982, are reviewed. Twenty-six cases are analyzed clinically and 25 cases are reexamined microscopically. Classification of the tumor and clinical staging are based on the National Wilms' Tumor Study. The clinical group Ⅰ, Ⅱ, Ⅲ were 13, 6, 7 cases, respectively. The epithelial predominent, mixed, blastemal predominent and stromal predominent types were 3, 8, 5 and 9 cases, respectively. Eleven cases showed diffuse anaplasia. Four of them were stromal, diffuse anaplasia and the types of malignancy were rhabdomyosarcoma(3 cases) and clear cell sarcoma(1 case). Gross findings of the tumors were greatly variable, however, those matched well to the microscopic findings. So classification based on gross as well as microscopic findings was thought to be superior to that based on simple collection of microscopic slides. Five cases showing no evidence of recurrence or metastasis during the period of follow-up more than one year and two cases with metastasis but survival over 2 years are classified into good prognostic group. Four of them were stromal, no anaplasia type and clinical group 1. Six cases showing widespread metastasis or rapid recurrence of tumor resulting in death or giving up the treatment were classified into poor prognostic group. Factors related to their poor prognosis were older age, high clinical stage and histologic features of anaplasia. All the cases with poor prognosis showed evidences of recurrence or metastasis within one year. The resected kidneys of the cases with good prognosis was heavier than those of the cases with poor prognosis. Six cases showed significant rhabdoid differentiation. Three cases were associated with renal dysplasia. Two cases were adult Wilms' tumor.

Effect of the Nitrofen on Diaphragmatic Development of Rat: Wha Soon Chung, Je Geun Chi*; Korean J Pathol. 1984;18(2):122-135.

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Abstract: Enormous increase of use of herbicide was brought to problem with adverse effect on environment and its inhabitant. And the refatogenic effects of a few herbivides were reported. Nitrofen, 2,3-dichlorphenyl-p-nitrophenyl ether is an organic chemical placed in nitrophenol/aniline group. This chemical has been one of most widely used herbicides in Korea. Initial toxicity study of nitrofen was done by Ambrose with lung toxicity. Respiratory distress and cyanosis of neonatal rats following nitrofen exposure in uterus was descibed by Kimbrough et al and suggested that nitrofen might be affecting surfactant production. Later, it was reported that cardiac naomaly accounted for the neomatal distress and death. This experiment was attempted to produce diaphragmatic defect in offsprings of rats by nitrofen administration orally in early developmental stage and to find characteristics of diaphragmatic defect. Following results and conclusions were made. 1) Nitrofen was a potent teratogenic agent in rats in dose of 350 mg/kg at 10th day of gestation. It was fairly selective in producing diaphragmatic defect. The overall frequency of diaphragmatic defect was 66.3%. 2) Diaphragm was the primary target organ in nitrofen induced neonatal death, and pulmonary hypoplasia due to diaphramatic defect was major contributor of direct cause of neonatal death. 3) In majority the defect was in the posterolateral(Bochdalek) portion of the ddiaphragm and in some cases, diaphragmatic defect was due to attenuation of central tendon. 4) The difference in the sidedness of the defect was obviously noted; in group of administration of 250 mg/ kg at gestation 11th day, the great majority were right sided(92%), while in group of administration of 350 mg/kg at gestation 10th day no difference was observed. 5) Pathogenesis of nitrofen induced diaphragmatic defect was thought probable due to delay or arrest of development of pleuroperitoneal fold.

Benign Glandular Inclusions in Pelvic Lymph Nodes -Histopathologic Observation with special reference to histogenesis-: Yong Il Kim, Hae Jae Cho; Korean J Pathol. 1984;18(2):136-143.

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Abstract: Benign glandular inclusions(BGI) are nonneoplastic glandular structures which are not infrequent in pelvic lymph nodes, and the chance of finding these structures is dependent on the intensity with which one searches. We examined the pelvic lymph nodes from total 189 consecutive cases of radical hysterectomy for uterine malignancies performed at Seoul National University Hospital over a period of two years from January, 1979 to June, 1981. These lymph nodes revealed glandular inclusions in fifteen(7.9%) of the 189 cases. Over 50 of BGI were located either in the capsule or subcapsular portion of lymph nodes. These were reflected by simple microcysts of tubes with a single layer of cilliated cuboidal or columnar epithelium whichresembled the epithelial cells lining the endosalpinx, endocervical and endometrial glands. In serial sections of lymph nodes with benign gladular inclusions, the following characteristic findings were observed. First, these structures were extending from nodal capsular tissue to the adjacent subcapsular portion of cortex and often invaginated into the medullar along the fibrous trabevulae ; secondly BGIs were not identifiable within the peripheral sinuses; thirdly these were often racemous and communicating ; and fourthly, admixture of both serous and mucinous linings in a same lymph nodes were present. Bu these findings we propose that the benign glandular inclusions may be due to localized metaplasic proliferation of the peritoneal mesothelium which is derivative of coelomic epithelium from which the Mullerian system originates.

Evaluation of Glycosylated Hemoglobin Level by Hemoglobin Quick Column Method: In Ja Kim, Jay Sik Kim, Jyung Myung Kim; Korean J Pathol. 1984;18(2):144-151.

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Abstract: Glycosylated hemoglobin(G-Hb) measurements were performed in normal adults and adult-onset diabetics, and G-Hb values were compared by age, sex, duration of diabetes mellitus, complications of diabetes mellitus, and types of therapy. Mean value of G-Hb was 5.0±0.92% in normal control and 7.9±2.50% in diabetes mellitus. In diabetics, G-Hb values with blood glucose level at the time of G-Hb measurement and blood glucose level 2~3 weeks before G-Hb measurement were compared. No significant correlation was observed between blood glucose levels and G-Hb. No significant correlation between G-Hb value and sex, age, duration of diabetes mellitus, complications of diabetes mellitus and types of therapy.

A Clinical Study of Human Chorionic Gonadotropin Determined by Enzyme Immunoassay: Chun Hee Lee., Sook Ja Park, Ho Yeul Choi*; Korean J Pathol. 1984;18(2):152-157.

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Abstract: Human chorionic gonadotropin is a glycoprotein secreted by trophoblast. It has been determined by several methods, but resectly enzyme immunoassy is developed. The authors investigated serum levels of β-HCG determined by enzyme immunoassay in normal controls and patients with diseases of the reproductive organs. The results were as follows : 1) In hydatidiform mole, serum β-HCG levels were significantly increased(11.9×10³ mlU/Ml), but the elevated levels were returned to normal in 12 weeks after operation. 2) In choriocarcinoma, serum β-HCG levels were also markedly increased. 3) In ectopic pregnangy, serum β-HCG levels were increased moderately. 3) In chronic cervicitis and other diseases of the reproductive organs, serum β-HCG showed normal levels. According to the above results, enzyme immunoassay is a simple, rapid, highly specific, and sensititive method for determination of serum β-HCG. Evaluation of serum β-HCG levels is very important in diagnosis of trophoblastic disease and ectopic pregnancies.

An Experimental Study on the Effect of the Blastocyst to the Endometrial Stroma: Kyo Suck Woo, Ki Tae Keum, Chong Man Kim, Kook Hwae Koo; Korean J Pathol. 1984;18(2):158-163.

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Abstract: The present study was undertaken to investigate the developing mechanism and its biological significance of the decidua. Unilateral salpingeal ligation was performed on mature female Sprogue-Dawley rats. Mating was proceeded. On the 3rd, 5th, 7th, and 9th days of the pregnancy, morphological changes of both ligated (non-pregnant horn) and non-ligated (pregnant horn) salpinges were observed. Gradual change of the decidualization was observed already by the 5th day of the pregnancy in the non-ligated horn, but was not in ligated. Marked change of the decidualization was observed by the 7th and 9th days of pregnancy in the non-ligated horn, but little change was in the ligated. The results suggest that decidualization is contributed not only by endocrinological factors but also obviously by some factors of the blastocyst.

Gastric Adenoma : Its Clinico-Pathologic and Histopographic Analyses in Relationship with Gastric Carcinoma -Part Ⅰ : Morphological Characteristics-: Yong Il Kim, Woo Ho Kim; Korean J Pathol. 1984;18(2):164-173.

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Abstract: A total of 52 gastric adenomas from 32 resected stomachs were subjected for the extended histoto-pographic study and its clinico-pathologic correlations were made. Group Ⅰ (adenoma alone) comprised 25.0% of whole cases with gastric adenomas, group Ⅱ (separated adenoma and carcinoma in a samejo stomach) 46.9%, and group Ⅲ (microcarcinomatous focus in adenoma) 28.1%. The average age at the time of gastric resection was 57.4 years (32~82 years), but mostly it occurred in the eldery over the age of 60. The majority of adenomas were elevated and sessile, in flat or semiglobal from, and only 21.6% were pedunculated. Two lesions were of depressed type (of Ⅱc). There were usually ovoid (51.4%) or mulberry shaped (29.75), and their surfaces were evenly granular. The size was less than 2cm in 71.2%, and 82.7% of the adenoma were under 3cm in maximum cross. The average size of group Ⅲ was bigger than that of group Ⅰ and Ⅱ. Two thirds of gastric adenomas were located in the antral portion, and exclusively were along the lesser curvature when adenoma was single. The adenoma was mostly multiple (average 1.63 per stomach), and more numerous in group Ⅱ (2.20 per stomach). Hitologically tubular adenoma comprised 94..2% and the reminders were papillary adenoma. S conceptual critique on the usage of atypical epithelial or borderline epithelial lesion was made.

Squamous Cell Carcinoma of Skin Metastatized to Heart: Soon Lee, Sam Im Choi, Sang Ho Kim; Korean J Pathol. 1984;18(2):174-178.

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Abstract: We have experienced a case of squamous cell carcinoma of the anterior chest wall skin metastatized to the heart in a 55 year ole man. He had two ulcerative skin lesions diagnosed as quamous cell carcinoma, one being on the right auricle and the other on the left lower abdominal wall. The histopathological findings of this rare case and pertinent literature were reviewed briefly.

Primary Squamous Cell Carcinoma of the Thyroid Gland -A report of cases-: Ki Hwa Yang, Ahn Hee Lee, Byoung Kee Kim, Sun Moo Kim; Korean J Pathol. 1984;18(2):179-183.

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Abstract: Primary squamous cell carcinoma is a rare malignant tumor of the thyroid gland. It was firstly descibed by von Karst in 1858. Although the histogenetic origin of squamous cell carcinoma of the thyroid has been debated, squamous metaplasia of the follicular cells is most widely accepted histogenetic theory for this neoplasm. The authors experienced two cases of primary squamous cell carcinoma of the thyroid gland. The first case was a 64 years old male patient who had been suffered due to suddenly developed palpable mass on the anterior neck, two months prior to entry. On operation, there was an ill defined nodular mass, 3cm in diameer, on the left lower thyroid. It had homogeneous light yellow cut surface with firm consistency. Microscopically, the thyroid follicles were replaced by dense fibrous tissue containing nests of neoplastic squamous cell. There was marked chronic inflammatory cell infiltration in the fibrous tissue. The second case was a 52 years old male patient who had been suffered because of painful palpable mass on the anterior neck for 20 days. He had been showed hoarseness since eight month prior to entry. Laryngoscopic examination revealed paralysis of the right vocal cord, but other pathological findings were not found. On operation, the thyroid gland was fixed to the trachea. Both lobes of the thyroid showed homogeneous tan brown cut surface with focal honey-comb appearance and diffuse light yellow miliary infiltration. Microscopically, there were numerous nests of neoplastic squamous cells with keratin pearls. Benign metaplastic squamous cells were observed around the carcinoma lesion. transitional zone between the metaplastic squamous cells and follicular epithelial cells were observed. Some follicles were entrapped within the neoplastic tissue.

Ectopic Paragonimiasis in Omentum and Prepatellar Bursa: Hye Suk Song, Jang Sihn Sohn*, Chae Hong Suh; Korean J Pathol. 1984;18(2):184-187.

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Abstract: Two cases of ectopic Paragonimiasis together with a brief review of literature are presented. The one, 41-year-old Korean male patient was admitted to Christian Hospital Kwangju, beccause of periumbilival pain and palpable mass for 2days. The cut surface of surgical excision mass reveals variable sized cystic spaces with focal necrosis. The histological findings reveal chronic granulomatous inflammation with prominent fibrosis and many thick-shelled eggs of Paragonimus westermani. The skin test for P.W. was positive. The other case, 23-year-old Korean female was visited to local clinic, due to freely movable mass on the prepatellar area. Surgical excision mass reveals two fragments of grayish white calcified soft tissue. Histologically, many calcified eggs of P.W. are observed.

Spindle Cell Carcinoma of the Esophagus -A report of a case-: Ki Hwa Yang, Byoung Kee Kim, Sang In Shim, Sun Moo Kim; Korean J Pathol. 1984;18(2):188-192.

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Abstract: Spindle cell carcinoma is very rare variant of squamous cell carcinoma. This variant had been included in the carcinosarcoma, and also confused with pseudosarcoma. The spindle cell component was proved as squamous cell by electron microscopic examination and tissue culture study. The authors experienced a case of spindle cell cariant of squamous cell carcinoma of the esophagus in a 67 years old male patient. He had been suffered from dysphagia and postprandial chest pain for five month. About ten kilogram of weight was lost during four months prior to this entry. An esophagogram revealed a filling defect of barium on the mid-esophagus, suggesting of a polyp. Laboratory findings, including hemogram, blood chemistry, urinalysis and direct smeaar of sputum for acid-fast bacilli, were all within normal limits. A segmental resection of the esophagus with esophagogastrosomy was performed. On gross examination, there was a polypoid mass, 3.7×2.5×2.0cm, on the esophageal mucosa. It revealed dark brown and dirty surface with firm consistency. On cut section, it showed tan gray to light yellow rough trabeculated cut surface. On the microscopic examination, it was composed of spindle shaped cells with interlacing or whorling pattern. In several areas, bizzare multinucleated tumor giant cells were observed. Varying amount of collagen and reticulin fibers were noted. There were intraepithelial squamous cell carcinoma near the stalk of the polyp, and islands of squamous cells in the spindle cell component. A distinct transitional zone was observed.

Acardius Acephalus -A case report-: Ho Won Hwang, Hye Suk Song, Young Chin Park, Chae Hong Suh; Korean J Pathol. 1984;18(2):193-196.

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Abstract: Acardius is more uncommon situation that occur in a pair of monozygotic twin. Abnormal fetuses of this variety are never found in single pregnancies, and circulation of blood is only by virtue of communication with the vessels supplying the normal twin. Acardia shows various other defects in addition to the absence of heart. The most common form is the acardius acephalus, they are headless and lack thoracic organs and upper extremities. The abdominal organs might contain remnants of liver, spleen, kidney, or intestine. Underdeveloped gonads are occasionally found. Recently authers experienced a acadius acephalus in 28 year-old female and herein reported with literature review.

Thymic Carcinoma arising from Multilocular Thymic Cyst: Youn Wha Kim, Ju Hie Lee, Jung Dal Lee; Korean J Pathol. 1984;18(2):197-202.

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Abstract: The case report dealt with a rare case of thymic carcinoma arising from multilocular thymic cyst in a 59 year-old female. The peculiar presentation of tumor made clinical diagnosis of thymic origin impossible even after many sophisticated clinical studies, and pericardial effusion as a most likely diagnosis was suggested. The pathologic study of the specimen removed surgically revealed a multilocular thymic cyst with focal carcinomatous transformation in an area. The carcinoma had histological features of a basal cell carcinoma elsewhere. The clinical manifestation and pathogenesis of the tumor were fully discussed with relevant literature.

A Case Report of Ependymoblastoma: H.I. Kim, H.T. Kim, A.J. Park, T.S. Park, Je G. Chi*; Korean J Pathol. 1984;18(2):203-208.

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Abstract: Ependymoblastomas arise from the cells lining the central ventricular system and the central canal of spinal cord. It is very rare type of primitive glioma which has a characteristic regular pattern of solid cords around thin walled blood vessel, forming an arrangement of perivascular pseudorosetters and/or typical ependymal rosettes in local areas. It is rapidly growing and diffusely infiltrating tumor, especially in childhood. Over than half of all ependymoblastomas occur in young ages. Ependymoblastomas have been described a few different terms and different definitions by several authors, such as malignant ependymoma, anaplastic ependymoma, ependymoma grade Ⅲ and Ⅳ, and so on. We experienced one case of primitive glioma which can be regarded as ependymoblastoma arising at the carebellar vermis in eight year old boy, who has complained of vomiting, ataxia and diplopia. The signs of increased intracranial pressure, i. e. papilledema and separation of suture Line in brain scanning were noted. The submitted sepecimen (S-83-1785) consisted of five fragments of pinkish brown irregular shaped tissue, 1 cm in the length of the largest mass. Microscopically the tumor mass was composed of relatively uniformed glial cells, arranged in perivascular area, forming multiple layer and vascular changes with partly necrotic granulomatous area. Te individual cells are small round with hyperchromatic nuclei and significant number of mitotic figures. The above clinicopathologic findings are compatible with ependymoblastoma.

Mesenchymal Chondrosarcoma Arising in Extraskeletal Soft Tissue -Report of a case-: In Sun Jun, In Soo Seo*, Man Ha Huh; Korean J Pathol. 1984;18(2):209-213.

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Abstract: A case of extraskeletal mesenchmal chondrosarcoma is presented in a 31 year old woman. The tumor occurred in the soft tissue overlying posteromedial aspect of the right tibial midshaft. The literature was reviewed and, to our knowledge, this is the first reported case in Korea. The tumor measured 9.0×5.0×4.0 cm, and was firm in consistency and yellow in color. Cut surface showed yellowish brown fibrotic surface with central calcification. The hisologic findings were characterized by islands of well differentiated cartilage and by undifferentiated mesenchmal tissue composed of sheets or lobules of small tumor cells arranged in a hemangiopericytomatous configuration, confirming the histopathological findings in the previously published reports.

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