Journal of Pathology and Translational Medicine

Volume 16(1); May 2005

Review

Diagnostic Guideline of Fine Needle Aspiration Cytology of Thyroid Gland and Cytopathologic Features of Papillary Carcinoma.: Soon Won Hong; Korean J Cytopathol. 2005;16(1):1-9.

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Abstract PDF: No abstract available.

Etcs

Phenotypic and Genotypic Frequencies in Rh negative Koreans -An analysis of 200 cases-: Young Chul Oh, Che Kyoung Moon, Dong Wha Lee, Duk Yong Kang; Korean J Cytopathol. 1982;16(1):1-3.

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Abstract: The author investigated frequencies of phenotype and genotype in 200 Rh negative Koreans during 7 years from January, 1975 to September, 1981, with brief review of Japanese and Europian literatures. In 200 Rh negative Koreans, the distribution of Rh phenotypes and most likely genotypes are as follows: ccdee (cde/cde) 60%, Ccdee (Cde/cde) 23.5%, ccdEe (cdE/cde) 10%, CcdEe (Cde/cdE or CdE/cde) 40%, CCdee (Cde/Cde) 2.0% and ccdEE (cdE/cdE) 0.5%

A Study on the Serum Lysozyme Value in Patients with Leukemia: Hyon-Sok Kim, Kyung Soon Song, Samuel Y. Lee, Yun Woong Ko*; Korean J Cytopathol. 1982;16(1):4-12.

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Abstract: Since the Fleming's observation of bacteriolytic element in nasal mucus in 1922, lysozyme has been found to be present in various biologic fluids such as serum, urine, tear, colostrum etc. It is known to be a hydrolytic enzyme acting specifically on the structural unit of cell wall of various bacteria. In the formed elements of blood, lysozyme activity has been identified in monocytes, monoblasts and mature neutrophils and their precursors as far back as progranulocytes. Increased concentrations of lysozyme were reported in the serum and urine of patients suffering from monocytic and myelomoncytic leukemias. The activities of lysozyme are normal or decreased in lymphocytic leukemia. Attempts have been made to correlate the serum lysozyme value with diagnostic and prognostic indices of acute leukemia. However, there has been no report on the serum lysozyme study in Korea. The author measured serum lysozyme level by means of turbidimetric assay on 48 specimens from 42 patients with leukemia and 30 from normal subjects. 1) In normal subjects, the mean value of lysozyme was 7.46㎍/㎖ and the range was 3.25～11.25㎍/㎖. 2) The highest mean serum lysozyme level was found in AMMoL patients(22.7㎍/㎖). Increased level was also observed in AMoL group(16.31㎍/㎖). 3) There was some correlation between serum lysozyme level and leukocyte count but it was not significant statistically (r=0.24). 4) The mean of the ratio of serum lysozyme/WBC count per ㎕×10-3 was above 4 in AMoL. The mean of the ratio in other types of leukemia was significantly different (p<0.005). 5) When lymphadenopathy accompanied by gum hypertrophy was present in AMMoL and AMoL, an increased serum lysozyme value was also observed. 6) When initial serum lysozyme level was high, the remission rate was low in AMMoL and AMoL. From the above results, it is concluded that the measurement of serum lysozyme value is an additional guide for the diagnosis and prognosis of acute leukemia.

Original Article

Clinical Efficacy of Manual Liquid-Based Cervicovaginal CytologyPreparation: Comparative Study with Conventional Papanicolaou Test.: Jong Myoung Park, Jong Gi Lee, In Soo Suh; Korean J Cytopathol. 2005;16(1):10-17.

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Abstract PDF: This study was performed to compare manual liquid-based preparation with conventional Papanicolaou tests in view of the cytologic diagnoses and specimen adequacy. The specimens of 5,979 women from 33 local clinics and 1 general hospital were prepared by both manual liquid-based preparation and conventional Papanicolaou test. The cytologic diagnoses and specimen adequacy were evaluated in Department of Pathology in Kyoungpook National University School of Medicine. A conventional Papanicolaou test was always prepared first, after that residual material on the sampling device was rinsed into a liquid preservative, and then thin-layer slides were prepared using manual method of liquid-based cervicovaginal cytology. Conventional and liquid-based slides were read independently, and cytologic diagnoses and specimen adequacy were classified using the Bethesda System. Of the cases, 5,763(96.3%) had the same interpretation, and there was no significant diagnostic difference in 5,853(97.8%) cases. When evaluating cases with more than one diagnostic class difference, the manual liquid-based preparation demonstrated a statistically significant overall improvement(2.1%) in the detection of squamous intraepithelial lesion and invasive cancer. Using manual method of liquid- based preparation, there was 14.1% reduction in unsatisfactory slides through excellent cellular presentations. In conclusion, the manual liquid-based preparation produces standardized quality, superior sensitivity and improved adequacy as compared to the conventional method.

Etc

Effects of Storage on Immunoglobulin Concentration in Stored ACD Blood: In Sun Jun, Man Ha Huh; Korean J Cytopathol. 1982;16(1):13-18.

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Abstract: The present study was undertaken to assess the effects of storage on the stability of plasma immunoglobulins(IgG, IgA, IgM and IgD) in ACD stored blood after periods of storage up to 12 weeks at 4℃. 1) Blood was drawn from 5 healthy volunteer donors into acid-citrate-dextrose(ACD) anticoagulant containers and placed in the blood bank refrigerator. Plasma immunoglobulins were measured on all samples initially and every week up to 12 weeks of storage at 4℃. Plasma immunoglobulins were measured by single radial immunodiffusion method. 2) Results of analyses are presented and discussed. The coefficient of variation of test samples is compared with that of standard quality control data (IgG: 8.8%, IgA: 7.9%, IgM: 9.5% and IgD: 9.3%) 3) No significant differences were found in the concentrations of immunoglobulins compared with the initial concentrations at the 3rd week (expiration date) and the 12th week.

Original Article

The Usefulness of Concomitant High-Risk Human Papillomavirus Test and Colposcopy in Combination with the Papanicolaou Test in ASCUS Patients.: Min Kyung Kim, Jin Hee Sohn, Chul Hwan Kim, Jong Sang Choi; Korean J Cytopathol. 2005;16(1):18-24.

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Abstract PDF: The objective of this study was to ascertain whether or not the high-risk human papillomavirus(HPV) test, when coupled with Papanicolaou(Pap) smears, would prove useful in the screening and management of patients in whom abnormal Pap smear results had been obtained. Concomitant high-risk HPV detection using the hybrid capture II test and colposcopy with a Pap smear were performed with 176 patients, all of whom had been screened for both cervical carcinoma and precancerous lesions. We concomitantly performed colposcopies on these patients. Upon the follow-ups, the histologic diagnoses of these patients were confirmed via either biopsy or hysterectomy. The rate of high-risk HPV detection was correlated with cytologic diagnoses and colposcopic findings. The group composed of the high-risk HPV-positive ASCUS patients exhibited a 55.7% rate of cervical intraepithelial neoplasia(CIN), a significantly higher rate than the 7.5% result obtained in the high-risk HPV- negative ASCUS group. HPV test showed high sensitivity(87%) and low specificity (62.6%) in detection of CIN and colposcopy also showed high sensitivity (88%) and low specificity(22%). Any combination of these tests improve sensitivity, but not specificity. High-risk HPV tests, when coupled with Pap smears, constituted a useful triage approach with regard to colposcopy-directed biopsies in patients in whom a cytologic diagnosis of ASCUS had been rendered.

Etc

Clinicopathological Study of Primary Mucinous Ovarian Tumor According to the Number of Mitosis: Chan Il Park, Dong Whan Shin, In Joon Choi, Myung Sook Yoo*, In Seo Park*, Hyo Sook Park**; Korean J Cytopathol. 1982;16(1):19-26.

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Abstract: After Scully divided the primary ovarian epithelial tumors into benign, borderline and malignant varieties, it has been repeatedly emphasized that there are appreciable differences in terms of prognosis in each group. However there may be individual difference among examiners when the pathological diagnosis is made on the basis of complex interpretation of the nuclear pleomorphism, mode of proliferation, frequency of mitosis and the presence of stromal invasion. In this study histological grading was made according to the frequency of mitosis, the most reliable index for the rate of cellular proliferation, in 98 mucinous ovarian tumors. Of the 98 subjects 80 cases belonged to the grade I (0～1 mitosis/HPF), and the grade II(2～3/HPF), III (4～5/HPF) and IV (> 5/HPF) tumors were seen in 11, 5 and 2 cases respectively. The degree of nuclear pleomorphism and the mode of cellular proliferation, such as the frequency and degree of papillary growth and secondary gland formation, corresponded well to the grades of tumors. Among the 98 mucinous tumors, seven cases (7.1%) showing stromal invasion were classified as malignant, irrespective of histologic grades, and all the grade I tumors but those with stromal invasion was grouped into benign, which comprised 80.6%. The remaining tumors were categorized into borderline malinancy which comprised 12.3% of all. The grade IV tumors showed smaller size and less multilocularity than the lower grade ones, suggesting that the higher-grade tumors tend to grow as solid mass rather than cystic locules. The short symptom-duration as well as the bilateral involvement were more likely of higher grade tumors. It was emphasized that one must pay regard to the frequency of mitosis when primary mucinous ovarian tumors were dealt with.

Case Report

Cytologic Features of Pseudoangiomatous Stromal Hyperplasia of the Breast: A Case Report with Review of Literature.: Jin Sook Lee, Jee Yeon Kim, Dong Hoon Shin, Do Youn Park, Kyung Un Choi, Chang Hoon Lee, Mee Young Sol; Korean J Cytopathol. 2005;16(1):25-30.

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Abstract PDF: Pseudoangiomatous stromal hyperplasia(PASH) was initially described by Vuitch et al. as a benign breast lesion, consisting of mammary stromal proliferations which simulate vascular lesions, and which might be mistaken for a low-grade angiosarcoma. This condition occasionally presents as a palpable mass in postmenopausal women, but is more frequently encountered as an incidental component in premenopausal women. Clinical, radiological, and fine-needle aspiration(FNA) findings associated with this condition can mimic those observed in conjunction with a phyllodes tumor or a fibroadenoma. The cytological features of PASH are generally nonspecific, and its diagnosis by FNA cytology is fairly difficult. In this study, we report a case of PASH, manifesting as a palpable mass

Etc

Ultrastructural changes of alveolar capilary endothelial cells induced by acute oxygen poisoning: Jong Min Chae, Jyung Sik Kwak, Tae Joong Sohn; Korean J Cytopathol. 1982;16(1):27-32.

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Abstract: The author carried out light microscopic and electron microscopic studies of alveolar capillary endothelial cells of rabbits after inhalation of pure oxygen in order to investigate oxygen toxicity on the endothelial cells and periodically observed after inhalation for 24,48,72,96, and 120 hours. The results were as follows. Light microscopically, congestion, edema, focal hemorrhage, and focal inflammatory infiltrates occurred within 24 hours of oxygen inhalation. Capillary proliferation and thickening of alveolar septa occurred at 72 hours of inhalation. Over 96 hours of inhalation thrombosis and focal necrosis appeared. Electron microscopically, pseudopod formation at 24 hours; mild swelling of Golgi apparatus and vacuolization of cytoplasm at 72 hours; loss of pseudopods, destruction and bleb formation of cell membrane, mitochondrial swelling, vacuolization of cytoplasm, and necrosis over 96 hours after oxygen inhalation appeared. Severity of degradation was more pronounced in the plasma membrane than in the cell organelles. From the above results, it is conceived that the endothelial cells fall in irritable state within 24 hours of pure oxygen inhalation and have irreversible injury over 96 hours of inhalation and that primary site of injury induced by oxygen toxicity is plasma membrane.

Case Report

Fine Needle Aspiration Cytology of Eccrine Acrospiroma of the Breast: Report of a Case Misdiagnosed as Ductal Carcinoma.: Young Ok Kim, Chang Wan Jeon, Hee Kyung Chang; Korean J Cytopathol. 2005;16(1):31-35.

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Abstract PDF: Eccrine acrospiroma is a rare adnexal tumor of the skin. When the clinical presentation is that of a breast lump, diagnosis can be difficult. Also, most of the cytopathologists are not familiar with the cytologic features of this tumor and this is responsible for diagnostic pitfalls. We experienced a case of eccrine acrospiroma of the right breast in a 41-year-old female, misdiagnosed by fine needle aspiration cytology(FNAC). FNAC was characterized by tight clusters or sheets of small round cells, polygonal cells, and spindle cells and tubule like structures within clusters. Myoepithelial cells were not noted in the clusters. The diagnosis of eccrine acrospiroma was confirmed by histology.

Etc

Reclassification of Malignant Lymphomas in Korean Patients According to Lukes and Collins Classification: Woo Hee Jung, Chan Il Park, Yoo Bock Lee; Korean J Cytopathol. 1982;16(1):33-42.

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Abstract: Since Thomas Hodgkin described tumors of the lymph nodes in 1832, morphologic classification of malignant lymphoma has been studied by various approached, and among them, the classification of Rappaport has been most widely accepted. But his approach entirely depended on morphology which failed to properly reflect the functional aspect of the component cells. With the recent development in the immunologic knwoledge of the lymphoreticular system and more acurate definition of various cells by histochemical methods, Lukes and Collins initiated a new approach to the classification of the malignant lymphomas taking the functional and histochemical aspects into consideration in 1974. For its proven usefulness in the clinical prognostication of the malignant lymphomas, this new concept has been widely disseminated. However, in Korea the old classification of Rappaport is still being used for largely technical reasons. In view of the recent trends of development in this important field, the author has made attempts at reclassification of the malignant lymphomas in Korea. The material consists of 142 cases of malignant lymphomas examined at the Department of Pathology, Yonsei University College of Medicine from January, 1975 through August, 1980. All cases were subjected to histopathological analysis and review of the clinical records. The paraffin blocks were sectioned serially at 5 micron thickness and sections were stained with hematoxylin and eosin and methyl green pyronin(MGP), and were examined by light microscopy up to the magnification of 1000 times. 1) Among 142 cases of malignant lymphomas, 111 cases (78%) were follicular enter cell type, and of the latter, 40 cases (28.2%) were "large noncleaved" type and 33 cases (23.2%) were "large cleaved" type. 2) Of the seventy-seven cases formerly diagnosed as "histiocytic" type according to Rappaport classification, 23 cases turned out to be "large cleaved" type and 22 cases, "large noncleaved" type. Thus 58.4% of the 77 cases proved to be of "large cell" line by the new approach. 3) There were no cases belonging to S?zary syndrome related to mycosis fungoides and small lymphocytic lymphomas in this study. 4) Of 130 cases of the malignant lymphomas in which the pattern of cell arrangement was clearly discernible, 97 cases (74.6%) demonstrated diffuse pattern of lymphomatous proliferation, and it was noted that all of the cases of plasmacytoid lymphocytic lymphomas and "small noncleaved" type, and also most of the cases of convoluted lymphocytic lymphoma, "large noncleaved" type and immunoblastic sarcoma showed this diffuse pattern. 5) Convoluted lymphocytic lymphoma predominantly occurred in adolescent and young adult male characteristically showing mediastinal mass, and the prognosis was poor because of generalized manifestation at the time of clinical diagnosis and the tendency of conversion to acute lymphoblastic leukemia. 6) While three quarters of the cases of "small cleaved", "large cleaved" and "large noncleaved" type showed partial or complete remission, most of the cases belonging to convoluted lymphocytic lymphoma and immunoblastic sarcoma resulted in poor prognosis clinically.

Case Reports

Fine Needle Aspiration Cytology of Mucoepidermoid Carcinoma of the Peripheral Lung: A Case Report.: Min Sung Choi, So Young Jin, Dong Won Kim, Dong Wha Lee; Korean J Cytopathol. 2005;16(1):36-40.

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Abstract PDF: The mucoepidermoid carcinoma is a rare tumor in the lung for less than 1% of all pulmonary neoplasm. It is mostly presented as a solitary pulmonary nodule at a large bronchial tree on bronchoscope. But more peripheral located tumor that not accessible to the bronchoscope are rarely reported on literature. The cytologic findings of these tumors are discribed as a mixture of squamous cells, mucous cells, and intermediate cells with overlapped cellular clusters. We experienced a case of peripheral mucoepidermoid carcinoma of lung diagnosed by fine needle aspiration cytology. The smear showed many cellular clusters on mucoid background. They consisted of many intermediate cells with occasional mucus-secreting cells, but malignant squamous cells were not present.

Fine Needle Aspiration Cytology of a Thymic Carcinoid Tumor: A Case Report.: Young Ha Oh, Ki Seok Jang, Young Soo Song, Chul Burm Lee, Choong Ki Park, Moon Hyang Park, Yong Wook Park; Korean J Cytopathol. 2005;16(1):41-46.

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Abstract PDF: Carcinoid tumors of the thymus are vanishingly rare, and the characteristic cytologic findings of this condition have never before been reported in Korea. Recently, we encountered a 58-year-old woman who had been suffering from general weakness and weight loss for several months. Radiological imaging revealed a large anterior mediastinal mass. A fine needle aspiration biopsy (FNAB) of the mass showed predominantly scattered single cells, as well as some loose clusters of small cells with scanty cytoplasm. Some of these small cells exhibited plasmacytoid features, with moderately granular cytoplasm. We also discuss the cytological differential diagnosis between thymic carcinoid and other mediastinal tumors.

Etc

An Experimental Study on the Changes of Serum Lipids in Rabbits with the Posthemorrhagic Anemia: Jin Q Kim; Korean J Cytopathol. 1982;16(1):43-51.

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Abstract: Serum lipids were estimated in 17 healthy rabbits as acontrol group and 9 rabbits with the experimentally induced posthemorrhagic anemia. Anemia was induced in rabbits by serial phlebotomy with the three to four days interval. At each time of the phlebotomy, about ten percent of the total blood volume was drawn out from the rabbits and the phlebotomy was performed six times during the study. The anemic group consisted of low hemoglobin group and low hematocrit group compared with the control group. Both the anemic groups of the rabbits had low serum lipids levels with a mean of 57 to 87 percent of the controls. A positive correlation was established in male anemic rabbits for hemoglobin and hematocrit with the HDL-Cholesterol, cholesterol, Total lipid and phospholipid, but not with Triglycerides. Female anemic rabbits remarked the positive correlation only with the Cholesterol. The correlation of reticulocytes production with the decrease of the serum lipids was not significant in statistics. This study shows the correlation of hematocrit decrease and hypocholesterolemia was more significant than that of the hemoglobin and hypocholesterolemia. In conclusion, plasma dilutional effect was considered to be an of the most plausible explanations as the mechanism of the hypolipidemia accompanying anemia, however, there may be several other contributory factors with complexities that should be studied.

Case Report

Fine Needle Aspiration Cytology of the Plasmablastic Lymphoma in Human Immunodeficiency Virus(HIV) Negative Patient: A Case Report.: Hyang Im Lee, Hyun Ryung Koo, Eun Mee Han, Gyungyub Gong, Chulwon Suh, Min Hee Ryu, Yoon Goo Kang, Chan Jeong Park, Jooryung Huh; Korean J Cytopathol. 2005;16(1):47-51.

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Abstract PDF: Plasmablastic lymphoma(PBL) is a recently described aggressive B-cell neoplasm, which usually manifests as a localized disease of the oral mucosa in individuals infected with human immunodeficiency virus(HIV). Recently, we encountered a case of plasmablastic lymphoma manifesting in the left maxillary sinus and cervical lymph node of a previously healthy HIV-negative man, 48 years of age. we conducted a fine-needle aspiration smear of the cervical lymph node, and this was found to be highly cellular with numerous large cells exhibiting eccentrically positioned nuclei, prominent nucleoli, and moderate quantities of basophilic cytoplasm. A biopsy of the mass in the maxillary sinus evidenced diffuse growth of similar plasmablastic cells. These tumor cells were negative for the leukocyte common antigens, CD20, CD3, CD30, and EMA. However, the cells tested positive for CD79a and CD138/syndecan-1. The tumor cells also exhibited L-light-chain restriction. The Ki-67 proliferation index was measured at almost 100%. The patient was diagnosed with plasmablastic lymphoma. After three cycles of combination chemotherapy and radiotherapy, the patient went into complete remission, and currently remains in this state.

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