Journal of Pathology and Translational Medicine

Volume 15(1); March 1981

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Clinico-Pathologic studies on Testicular and Peritesticular tumors: Jung ll Suh, Moon Hyang Park, Hyo Sook Park, Ku Young Choi*; J Pathol Transl Med. 1981;15(1):1-15.

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Abstract: The incidence of testis and their adnexal tumor is rare, but testicular tumors constitute the fourth most common cause of death from neoplasia in the age group of 15-34 years of age. No organs, except ovary, have so various type of neoplasia than testis that there is no reliable classification of testicular tumors recently, and the urologist must depend on the clinical stage and on histologic appearance of the tumor. Even Pathologists confuse the classification and characteristics of tumor because their limited experience, variable morphologic features and nomenclature of tumor. The authors collected thirty cases of testis and their adnexal tumors in the Pathology Department of National Medical Center from october 1961 to september 1980. We review the clinical records of the case and re-classify the pathologic diagnosis base on the WHO Classification proposed by Mostofi and Sobin. The results are as the follows. 1) According to histopathologic type, embryonal carcinoma, infantile type 8 cases(26.7%), teratoma 8 cases(26.7%), teratoma 8 cases(26.7%), seminoma 4 cases(13.3%) rhabdomyosarcoma 4 cases(13.3%), germ cell tumor showing more than one histologic pattern 2 cases(6.7%), mailgnant Iymphoma, Iymphocytic, poorly differentiated 1 case(3.3%), malignant mesothelioma 1 case(3.3%), testicular leukemic infiltration 1 case(3.3%) and capillary hemangioma 1 case (3.3%). 2) The mean age of each type is 33 yearn in seminoma, 2 2/12 years in embryonal carcinoma, infantile type, 1 10/12 year in 7 cases of teratoma, and 13 yeArs in rhabdomyosarcoma. 3) Primary testicular tumors occur in the scrotal sac(27 cases, 92%) and cryptorchid testis (2 cases, 8%), Two cases of cryptorchid testns show semieoma. 4) Bilateral testicular tumor is one among 29 cases(7%) 5) Scrotal mass or enlargment is most common chief complaint (74%) at diagnosis. 6) 14 cases (77%) received orchiectomy only an4 9 cases received orchiectomy and other therapy. 7) Metastasis is confirmed in 10 cases(43%) by clinical and operation findings. (clinical record is available in 23 cases among 30 cases).

Histopathologic Studies of Atypical Epithelial Changes in Fibrocystic Disease and Carcinoma of Breast: Giu Ran Kim, In Sun Kim, Seung Yong Paik; J Pathol Transl Med. 1981;15(1):16-22.

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Abstract: The relationship between fibrocystic disease and carcinama of the breast has teen discussed for many years. Thongu it is difficult to determine which of the histologic features of cystic disease has precancerous potential, recent reviews stress the possible relationship between atypical epithelial hy-perplasia and carcinoma. Author studied 51 radical mastectomized specimens of breast cancer and 44 excised specimens of fibrocystic disease, to compare the frequency of atypical hyperplasia of ducts and lobules in the benign and malignant lesions. The results are as follows: 1) Cystic change and sclerosing adenosis were the most common types of fibrocystic disease, and infiltrating scirrhous carcinoma was the most common type of breast cancer. 2) Apocrine metaplasia, ductal papillomatosis, lobular hyperplasia and sclerosing adenosis were more commonly seen in fibrocystic disease whereas atypical ductal and atypical lobular hyperplasia were common in cancer. The degree of atypia was severe in breast cancer. 3) Among fibrocystic disease, atypical ductal hyperplasia was frequently seen in the epithelial hyperplasia type. Among breast cancers, infiltrating comedo-carcinoma was frequently associated with atypical lesion of the duct. 4) Atypical lobular hyperplasia was frequently observed in the breasts of lobular carcinoma. However, the occurrence of atypical lobular hyperplasia in fibrocystic disease was rare.

A Study on HDL-chotesterol Levels in Normal and Disease Conditions: Yang Suk Chae, In Sun Kim, Seung Yong Paik; J Pathol Transl Med. 1981;15(1):23-28.

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Abstract: More than 25 years ago, Barr et al noted the negative relationship between high density lipoprotein (HDL) and the incidence of coronary artery disease. A number of studies supported for it. Recently it was known that HDL-cholesterol is more useful indicator of coronary heart disease than total cholesterol and triglyceride. Author studied the difference of HDL-cholesterol levels and HDL-cholesterol/total cholesterol ratio between normal male and female subjects, and HDL-cholesterol level in patients of coronary heart disease, diabetes mellitus, liver disease and gastrointestinal malignancies. The results are as follows: 1) Mean HDL-cholesterol level of normal subjects was 44.7± 12.4 mg/d1 and those of female and male were 48.7±14.2 mg/dl and 41.9±10.1 mg/dl respectively. 2) HDL-cholesterol/total cholesterol ratio in female was higher than that of male. 3) HDL-cholesterol level in normal subjects showed no significant changes with age. 4) The difference between HDL-cholesterol levels in patients of coronary heart disease and diabetes mellitus and that of normal subjects was insignificant. 5) HDL-cholesterol levels in patients of liver disease and gastrointestinal malignancies were lower than normal subjects.

Determination of Serum Total LD Activity and Isoenzymes in Various Liver Diseases: Jeong Ok Kang, Seung Hahm Park, Ki Hong Kim; J Pathol Transl Med. 1981;15(1):29-37.

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Abstract: Since LD is widely distributed in several organs and tissues, the serum total LD determination is not helpful in diagnosing a specific organ or tissue damage. But the separation of LD into five isoenzymes improves its specificity. Therefore it is used in the diagnosis of wide variety of conditions such as myocardial infarction, hepatobiliary diseases, pernicious anemia, renal diseases, progressive muscular dystrophy, and pulmonary embolism, etc. This study deals with serum total LD level and LD isoenzymes in various liver diseases such as viral hepatitis, toxic hepatitis, typhoid hepatitis, liver cirrhosis, cholecystitis and/or stone. The results as follows: 1) In normal controls, the mean total LD activity was 213±74 units and the LD isoenzyme distributions were LD2, LD1, LD3, LD4, and LD5 in decreasing order of activities. 2) In patient with viral hepatitis, the total LD activity was increased and also LD4 and LD5 were significantly increased. 3) In patient with liver cirrhosis, the serum totol LD activity was slightly increased but the LD isoenzyme distribution was within normal range. 4) In cholecystitis and/or stone, the total LD activity, LD4 and LD5 were all significantly increased but the degree of elevation was much less than viral hepatitis.

Clinical-Pathologic Studies on Salivary Gland Tumors: In Ki Paik, Il Hyang Ko; J Pathol Transl Med. 1981;15(1):38-44.

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Abstract: A statistical analysis was made on 40 cases of salivary gland tumors diagnosed at Seoul Paik Hospital, Inje Medical College from 1972-1980. 1) Histological classification revealed benign pleomorphic adenomas in 31 cases(77.5%), adenocarcinoma: 3 cases(75 1(2.5%), acinic cell adenocarcinoma; 1(2.5%), malignant pleomorphic adenoma : 1(2.51(2.5%), Iymphangioma, 1 (2.5%). 2) Mean age of patients with salivary tumor was 43.2 years and mean age for benign pleomorphic adenoma was 37.9 years. Mean age of carcinoma patients was 57.2 years. Overall sex distribution of salivary gland tumors was 25 cases for male and 15 cased for female. On benign pleomorphic adenoma, male/female was 18/13. 3) Distribution of the site is as follows: Parotid gland in 15 cases(37.5%), sublmandibular gland in 14 cases(35%), minor salivary gland in 10 cases(25%). Among benign pleomorphic adenoma, submandibular gland was the most favorite site with 13 cases(41.9%) out of 31. Among 7 cases of malignant lesions including 1 case of malignant pleomorphic adenoma, 4 cases occurred at the Parotid gland. 4) Mean size of the salivary gland tumors was 3.5 cm. Average size of benign pleomorphic adenoma was 3.4 cm including 1.7 cm for minor salivary gland and 4.0 cm for major salivary gland. Average size of carcinoma was 3.6 cm. 5) Mean value of time interval between onset of symptom and diagnosis was 5.3 years. For benign pleomorphic adenoma it was 5.4 years and carcinoma was 4.7 years. 6) Chief complaint was painless, slowly growing mass which is not filed, firm, nontender in almost every cases of both benign and malignant tumors of the salivary gland.

Study on Serum Total LD Activity and Isoenzymes in Liver Diseases: Soo Kun Kim, Soon Ho Kim; J Pathol Transl Med. 1981;15(1):45-52.

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Abstract: The authors investigated total serum LD activity and isoenzymes in 5 cases of acute hepatitis, 14 cases of chronic hepatitis, 25 cases of liver cirrhosis, 17 cases of hepatocellular carcinoma and 20 cases of healthy control. The sera were obtained from the anterior cubital veins of the patients and healthy control in Busan National University Hospital from June 1978 to July 1979. Total Serum LD activity was measured by method of Caboud-Wroblewski and isoenzyme fractions were analysed by cellulose acetate electrophoresis. The results obtained were as follows : 1) In the patients with liver diseases, total serum LD activity was significantly increases than that of healthy controls. 2) In the patients with liver diseases LD1 and LD2 were significantly decreased than those of healtly controls, while LD4 and LD5 were significantly increased. 3) The patterns of serum LD isoenzyme fractions showed LD2>LD1>LD3>LD4>LD5 in healtly adult, LD5>LD2>LD1>LD3>LD4 in acute hepatitis and LD2>LD1>LD3>LD5>LD4 in chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. 4) In the patients with liver diseases, the ratio of LD1+LD2/LD4+LD5X100 was significantly decreased than that of healthy control. 5) The diagram for the percent distribution of serum LD isoenzymes demonstrated that all the fractions of LD isoenzymes except LD3 : in acute hepatitis and LD5 in other liver diseases were out range (M±2 SD) of healthy control. On the basis of above, the authors consider that total serum LD activity, isoenzymes and diagram for the percent distribution of isoenzymes may be help of clinically in making diagnosis and differention of various liver diseases.

Histochemical Study of Salivary Gland Tumors: Dong Hwan Shin; J Pathol Transl Med. 1981;15(1):53-61.

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Abstract: Salivary gland tumors are unique among head and neck tumors in the wide array of pathology that they manifest. Billroth (1859) first described four different types of tissue in salivary gland tumors. Since then two theories, mesenchymal and epithelial, have prevailed as to the histogenesis of salivary gland tumors, particularly the so called mixed tumor. Nowadays, the epithelial theory, though not firmly established, enjoys wide support. Recent advances in histochemical techniques have helped to characterize and differentiate sugar containing compounds. Although there are a number of studies concerning the characteristics and distribution of mucoid material found in the salivary gland tumors, a more systematic histochemical study would to of help in the further investigation of the histogenesis of various salivary gland tumors. We have attempted to classify an assortment of salivary tumors on histological basis and performed histochemical studies using various special stains. Material and Methods The material consists of 110 salivary gland tumors examined at the Department of Pathology, Yonsei University College of Medicine between 1969 to 1979. All cases were subjected to histochemical analysis and further morphological study. The paraffin blocks were sectioned serially at 5-7μ and sections stained with hematoxylin and eosin, periodic acid-Schiff reagent (PAS), PAS after diastase digestion, Best's carmine, alcian blue, and toluidine blue. For control of toluidine blue staining, sections of umbilical cord were used. Results and Summary Following results are obtained from histopathologic studies and histochemical analysis on the 110 cases of salivary gland tumors. 1) Out of 110 cases 69 cases(62.7%) occurred at the major salvary gland and 76 cases(69.1%) were benign. 2) Of these major salivary gland tumors 15 cases(21.7%) were malignant while 16 cases (44.4%) of minor salivary gland tumors(total of 36 cases) were malignant. 3) In all salivary glands, there was a striking predominance of pleomorphic adenoma comprising 72 cases(65.5%) of salivary gland tumors. The second largest group observed was adenoid cystic carcinoma followed by mucoepidermoid tumor. 4) Mucoid material found in the ductal lumen of pleonlorphic adenoma, mucoepidermoid tumor and adenoid cystic carcinoma was diastase-reaistant PAS positive. Material in the pseudocystic spaces of adenoid cystic carcinoma was strongly alcian blue positive, toluidine blue positive, and metachromatic. 5) Mucoid material in the stroma of salivary gland tumor was alcian blue positive, toluidine blue-positive and metachromatic. Results of the present study indicated that the epithelial cells of pleomorphic adenoma, mucoepidermoid tumor and Warthin's tumor in addition to the duct lining cells of adenoid cystic carcinoma were derived from duct epithelia which secrete neutral mucopolysaccharide. The cells forming both pseduocyst in the adenoid cystic carcinoma and chondromyxoid area in the pleomorphlc adenoma were thought to originate from mesenchymal cells which secrete acid mucopolysaccaride.

A Case of Essential Thrombocythemia: Jang Sihn Sohn, Sook Ja Park; J Pathol Transl Med. 1981;15(1):62-66.

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Abstract: A case of essential thrombocythemia was presented Essential thrombocythemia is one of the myeloproliferative disorder in which the major abnormality is the excessive production of megakaryocytes and platelets and is a rare disease. Describe here a case (60 years old female) of essential thrombocythemia with laboratory findings, clinical course and brief review of literature.

Campylobacter fetus Septicemia in a Patient with Liver Cirrhosis and Diabetes Mellitus: Kyung Won Lee, Ae Ja Park, YunSop Chong, Samul Y. Lee, Heung Jai Choi*; J Pathol Transl Med. 1981;15(1):67-72.

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Abstract: Bacteremic infection of Campylobacter fetus in man is a rare disease. In October 1980, C. fetus subsp. intestinalis was isolated from blood specimens of a 57-fear-old male with liver cirrhosis and diabetes mellitus. Ascites from the same patient did not show any growth. Clinical status of; the patient and bacteriological characteristics of the isolate were herewith presented. Also presented is a review of our 3 previous cases. 1) All of the 4isolates from the patients of Yonsei Medical Center were C. fetus sutsp. intestinalis. 2) All of the 4 patients were males of 38-year-old or over. They had one or more of underlying diseases such as subacute bacterial endocarditis, colon carcinoma, diabetes mellitus and liver cirrhosis etc. Three out of four patients expired. 3) The patients showed fever of 36,6-38.5。C and WBC count of 3,100-33,900/μ1 with 74-96% segmented neutrophils. 4) The positive cultures were defected after a long incubation of 4-12 days in brain heart infusion, tryptic soy broth or thioglycollate medium. The isolates were susceptible to practically all antibiotics tested.

Gaucher Cells in Chronic Myelogenous Leukemia: Myung Hee Kang, Jung Dal Lee; J Pathol Transl Med. 1981;15(1):73-78.

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Abstract: This report concerned two cases of chronic myelogenous leukemia with Gaucher cells in their bone marrow aspirates. Light microscopic characteristics of and a few cytochemical reactions on the acquired Gaucher cells were described. These cells were ligh tmicroscopically similar to the hereditary Gaucher cells. The origin of the acquired Gaucher cells in chronic myelogenous leukemia was discussed.

A Case Report of Paroxysmal Cold Hemoglobinuria Associated with Syphilis: Man Soo Song, Jin Young Kim, Kook Young Maeng, Hung Kyu Ro; J Pathol Transl Med. 1981;15(1):79-84.

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Abstract: One case of rare autoimmune hemolytic syndrome, paroxysmal cold hemoglobinuria (PCH) is reported. PCH is one of the rarest of the autoimmune hemolytic syndrome, characterized by acute intermittent hemolysis, frequently with hemoglobinuria, abdominal pain and periodic attacks of fever, following local or general exposure to cold, and then a positive Donath-Landsteiner test, positive Ehrlich reaction test, occasionally positive Rosenbach test, and/or often associated with syphilis and recent viral infection. The present case was admitted with chief complaints of headache, dizziness and occasionally abdominal pain. According to several : laboratory findings, the case which we have presented here was thought to be compatible with paroxysmal cold hemoglobinuria associated with syphilis. The patient appeared to show poor clinical improvement in response to prednisolone in dose of 30mg per day, blood transfusion and other conservative management.

A Case of Malignant Histiocytosis with Cutaneous Involvement and Eosinophilia: Jin Kim, Chan Il Park, In Joon Choi; J Pathol Transl Med. 1981;15(1):85-88.

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Abstract: Malignant histiocytosis is a fatal disease characterized by systemic proliferation of atypical, neoplastic and erythrophagocytic histiocytes. A Case of malignant histiocytosis with multiple nodular cutaneous involvement and eosinoptilia, in a 18 year-old male, was diagnosed on the third skin biopsy and reported. The first and second biopies shoved polymorphous, cellular infiltrates around the blood vessel and skin appendages in the lower dermis and diffuse infiltrates in the subcutaneous tissue. The infiltrates were composed of histiocytes, eosinophils, Iymphocytes and plasma cells without significant cellular atypism or abnormal mitoses. The third biopsy, which was performed 6 months later, when he readmitte4 due to aggrevation of the symptoms, showed monomorphous atypical histiocytic infiltrate with cellular atypism, abnormal mitoses, and erythrophagocytosis. Eosinophils, Iymphocytes and plasma cell infiltrates were markedly decreased. Brief review of the literatures with special reference to the association of cutaneous involvement and eosinophilia was made.

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