Journal of Pathology and Translational Medicine

Volume 11(2); July 1977

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The Study on Cytopathological Diagnosis of Carcinoma of the Lung: Dong Wha Lee, In Joon Choi, Yoo Bock Lee, Dong Sik Kim; J Pathol Transl Med. 1977;11(2):87-95.

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Abstract: No report on cytopathology of the lung cancer is published in Korea. For this reason, the present study is to describe the positivity of cytologic examination and accuracy of cytologic cell typing for cancer of the lung with the cases histologically diagnosed. Cytopathological evaluation of a total of 89 cases of cancer of the lung, both cytopathologically and histologically examined, was Performed, from January 1973 to June 1975 at the department of pathology, Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea. 1. Among 89 crises, the frequency was as fellows: epidermoid carcinoma, 61.8% : undifferentiated small cell carcinoma, 20.22%: bronchogenic adenocarcinoma and metastatic carcinoma, 4.5%. 2. Age and sex incidences were 82.01% distribution over the age of 40 and male preponderance. 3. Both sputum and bronchial washing show positive cytology in 68 (76.4%) of 89 cases and negative cytology in 21 cases(23.6%). The rate of cytopathologic diagnosis higher in epidermoid carcinoma, 87. 2%, and alveolar cell carcinoma, 100%, but was lessor in bronchogenic adenocarcinoma, 62. 5%, and undifferentiated small cell carcinoma, 61. 1%. 4. The positivity in sputum only was 58(67.44%) of 86 crises examined, and in bronchial washing only was 46 (69.70%) of 66 cases examined. 5. Of the 58 positive sputum cytology cases, positivity in first sputum was 32 crises(55.2%) and in three successive sputum samples was increased to 94.9%. So, three successive sputum examination was recommended for minimum requirement in routine procedure to obtain higher diagnostic rate. 6. Consistent rate of cytopathologic diagnosis with histologic diagnosis was differ in cell type as fellows; epidermoid carcinoma, 44(91.67%) of 48 cases; undifferentiated small cell carcinoma, 10(90.91%) of 11 cases examined; bronchogenic adenocarcinoma, 4 of 5 cased (85%); alveolar cell carcinoma, 4 of 4 cases (100%). In summary, the positivity of the sputum and bronchial washings was about 70% and almost same. Cytopathological diagnosis, for cell type of cancer of the lung was apparently quite accurate. There, however, was no significant difference and meaning in raising positivity over 3 Successive Sputum Samples.

Studies on Blastogenesis and T-Rostte Formation of Human Peripheral Blood Lymphocyte: Se-Ho Kim, Sang-ln Kim*, Kil-Soo Park; J Pathol Transl Med. 1977;11(2):97-111.

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Abstract: Various techniques to detect the immundozical functions of the lymphocytes has been developed. The authors establishing a stable techniques, performed the quantitations of rosette forming T-Iymphocyte(RP-TL) and phytohemagglutinin(PHA) stimulated Iymphocyte transformation rate(LTR) with 3H-thymidine uptake in in-vitro culture to define the characteristics of cellular immunity of Korean children, adults, and aged persons together with patients in various diseases. To standardize the potency of PHA, the authors used self-made saline extract of phaseolus vulgaris(PV) standardized by commercially available PHA. The results are summarized as follows : 1) The proportion of RF-TL was variable depending on individuality of sheeps ranging from 32±8.1 to 70.1±5.6% in total RF-TL and from 9.8±2.8 to 36.9±6.0% in active RF-TL in normal adnet. The most stable result was obtained by the concentration of 1.0% SRBC. 2) The proportion of total RF-TL in normal Koreans were 68.4±14.6% in adults, 65.6± 12.4% in children and 59.2±18.3% in old ages while the active RF-TL were 30.4±8.9% in children, 25.3±7, 4% in adults and 23.1±10.4% in old ages. 3) By means of our own self-made extract of P.V. the 3H-thymidine uptake of the peripheral blood lymphocytes was about 3% lower than that of foreign-made commercially available PHA but its blastogenesis was almost same with the latter. The PV-LTR were 68.6+17.6% in adult, 61.0+7.5% in old ages and 58.4±12.3% in children. 4) The RF-TL of cancer patients lower than that of normals and it was especially so in patients with extensive metastasis. The acute lymphoid leukemia patients disclosed the lowest RF-TL valves among the stuffy groups. 5) The PV-LTR in cancer patients was lowest in chronic lymphoid leukemia following the stomach cancer, lung cancer, hematoma, lymptoma and acute lymphoid leukemia in decreasing order of transformation rates. The PV-LTR were higher than normal controls in infectious mononucleosis and congenital syphilis while it was similar to normals in aplastic anemias. 6) The PV-LTR and RF-TL performed at the same time disclosed the following features ; a) In normal subjects, the RF-TL was lowest in old ages while the PV-LTR was lowest in children. b) In cancer patients, the PV-LTR was more significantly decreased than RF-TL suggesting more pronounced alteration or impairment of in vitro viability and/or DNA synthetic activity than the natural membrane-bound immune characters in their lymphocytes.

A Comparative Study of Lee-White Coagulation Time and Activated Coagulation Time (ACT) in Heparinized Rabbits: Kook Young Maeng; J Pathol Transl Med. 1977;11(2):113-118.

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Abstract: A comparative study of Lee-White coagulation time and activated coagulation time (ACT) using celite in heparinized rabbits was carried out. Initially, baseline values of both tests were measured before heparin administration. Then, heparin of varying dose (200unit/kg b.w. in one and 1000unit/kg b.w. in the other) were injected. Exactly after one hour, coagulation time and ACT were measured simultaneously using three syringe technic. Since then, coagulation time and ACT were measured at an hour interval every hour after heparin injection through 9 hour thereafter. Lee-White method was observed to be unstable and fluctuating, and to be poor measure for heparin monitoring. Values of ACT plotted on semilogarithmic graph, however, revealed linear drop reflecting semilogarithmic decay of anticoagulant effect of heparin injected. These observations were consistent with those observations of Hattersley, Bull and others, who said that ACT Precisely reflected semilogarithmic decay of heparin injected and preferred ACT to conventional Lee-White coagulation time in many clinical use including control of heparin therapy in various conditions.

Antibiotic Susceptibility of Clinical Isolates of Bacteria: Sook Ja Park, Yunsop Chong, Samuel Y. Lee; J Pathol Transl Med. 1977;11(2):119-125.

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Abstract: Antibiotic susceptibility test is an essential part of clinical bacteriology because many of the clinical isolates are resistant to various chemotherapeutic agents, and one can hardly predict the susceptibility without an appropriate laboratory procedure. According to the recommendation of WHO, Yonsei Medical Center Clinical Pathology has been using the Kirby-Bauer method. As a quality control, tests have been done using S. aureus ATCC 25923, E. coli ATCC 25922 and p. aerugosa ATCC 27853. This study was carried out to investigate the current susceptibility of clinical isolates to those antibiotics used most widely. The bacteria tested were isolated from the clinical specimens of Yonsei Medical Center between January to July of 1976. The following results were obtained. 1. Only 15% of S. aureus isolates were susceptible to penicillin. 92% were susceptible to cloxacillin, 97% to cephaloridine and 98% to minocycline. 2. Thirty eight per cent of enterococcus were susceptible to cephaloridine and to chloramphenicol. 3. Ninety three per cent of E. coli were susceptible to gentamicin. But the rates to chloramphenicol, streptomycin and tetracycline were very low. 4. The susceptibility rate of Klebsiella to gentamicin was 73%. To ampicillin, only 4% were susceptible. The rate of enterobactor to gentamicin was 74% and to ampicillin 9%. 5. Sixty seven Per cent of Citrobactr were susceptible to gentamicin. All of the serratia were susceptible to chloramphenicol, gentamicin and kanamycin. 6. The susceptibility rate of p. vulgaris was 88% to gentamicin an4 84% to kanamycin. The rates to gentamicin were p. mirabilis 76%, P. morganii 67% and P. rettgeri 60%. 7. All of the isolates of S. typhy were susceptible to ampicillin, chloramphenicol, gentamicin and kanamycin. 8. All of the Shigella isolates were susceptible to ampicillin, gentamicin and kanamycin. 9. Eighty one per cent of P. aeruginosa were susceptible to gentamicin and 80% of Alcaligens to minocycline. 10. The susceptibility rates of A. calcoaceticus were 75% to minocycline and 74% to gentamicin. 11. Minocycline showed higher rate of susceptibility than tetracycline in S. aureus, E. coli and A. calcoaceticus.

Isolation of β-hemolytic Streptococcus from Clinical Specimens: Kyung Soon Song, Yunsop Chong, Samuel Y. Lee; J Pathol Transl Med. 1977;11(2):127-131.

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Abstract: The streptococcal infections have become less frequent and less potent compared to those in the era of preantibiotics, but they still remain to be important in our clinical medicine as some of them result in rheumatic fever or acute glomerulonephritis. Appropriate bacterioogical studies would be of great value to aid the diagnosis, to guide the therapy and to prevent the sequelae. This paper will present some of the bacteriological studies related to streptococcal strains isolated from clinical materials at Yonsei Medical Center during the period of January 1976 to February 1977. 1. A total of 102 strains of group A was isolated. Specimens most frequently yielded group A streptococcus were pub, 43 or 42.2%, and throat culture, 24 or 23.5%. Blood culture yielded 8 or 7.8% and spinal fluid 2 or 2%. 2. As to the age group there were no particular relationship except for a decreasing frequency after the age of 40. 3. Isolation by month showed that group A streptococcus were most frequently isolated during the months of January to March, and August to November. 4. Excluding enterococci, there were a total of 117 bacitracin resistant strains; and these were presumptively identified as other than group A. Among these, 42 isolates were tested by capillary precipitation method to identify 6 of group A, 1 of B, 2 of C and 2 of G. 5. Some of the patients who yielded streptococcus other than group A had underlying diseases which were assumed to be the cause of the infections. 6. When streptococcus other than group A were isolated from either throat or sputum, only in a few patients those streptococci were predominant organisms; and it was hard to assume them as the causative organisms in rest of the patients.

A von Recklinghausen’s Disease with Association of Malignant Schwannoma of the Jejunum: C.C. Cho, O.J. Paik, S.K. Moon; J Pathol Transl Med. 1977;11(2):133-138.

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Abstract: This 39-year-old Korean woman has shown typical features of the von Recklinghausen’s neurofibromatosis, which is associated with a malignant schwannoma on the anti-mesenteric border of the jejunum. The presented case is characterized by the progressive generalized brown-pigment deposits over the skin and multiple cutaneous varying indurative masses, which have started to develop since about 10 years. Additionally, considerable deformities and changes in the skeletal system were demonstrated. The discussion about the clinicopathologic characteristics of the case, with literature review is described.

A Case of Primary Fibrous Histiocytoma of the Lung: Kye Sook Lee, Choon Won Kim, Kun Ho Kim, Ki Hong Kim; J Pathol Transl Med. 1977;11(2):141-147.

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Abstract: Fibrous histiocytoma had been introduced by Brunn in 1939 as a name of "tennis ball tumor", and also diagnosed with various names, such as xanthoma, xanthofibroma, xanthogranuloma, sclerosing hemangioma, histiocytoma and inflammatory pseudotumor. This tumor is originated from histiocyte and has occurred most commonly in skin, tendon, joint and soft tissue, but quite rarely has occurred in the lung. It has been reported about 40 cases in the world otherwise this case is probable for the first case in Korea. The authors here present a case of primary fibrous histiocytoma of the lung on September 1976. A 29-year-old Korean male was admitted to Han Yang University because of dyspnea and chest pain on right lower lung area. Chest X-ray revealed two large mass densities in right hilum and right lower lung field. A bilobectomy of upper and middle lobes of the right lung was performed which shows two well circumscribed masses measuring 4×2.5cm and 7×6cm in dimensions, respectively which was pale yellow in color and soft to friable consistency. Histopathologically, this tumor consists of histiocytes which is intermingled in the fibrous stroma with fibroblasts and fibrocytes arranged in a storiform pattern, and xanthomatous pattern of foam cells which is confirmed by the Masson trichrome, PAS, oil red O and reticulum stain.

A Case of Primary Reticulum Cell Sarcoma of the Breast -A Case Report and Literature Review-: Kye Sook Lee, Kyu Young Jun*, Choon Won Kim, Ki Hong Kim; J Pathol Transl Med. 1977;11(2):149-155.

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Abstract: A case of reticulum cell sarcoma of the breast is presented who is a 38-year-old Korean house wife and she died at twelfth day after simple mastectomy, but unfortunately we couldn’t knave autopsy and also we had a literature review of primary reticulum cell sarcoma of breast. Primary lymphosarcoma of the breast is relatively rare malignant neoplasm and rapidly progressive, aggressive disease in the majority. Radical surgery with supplemental irradiation of the breast is recommended. This tumor is consisted of well circumscribed hard mashes, measuring 3.0 X 3.0cm to 4.5×4.0cm, which has partial adhesion to the chest wall and multilocular cystic changes measuring 10×4cm which contains hemorrhagic content.

Chronic Ulcerative Colitic -3 cases report-: Soo Nam Rhee, Chin Hee Cho, Chong Moo Lee; J Pathol Transl Med. 1977;11(2):157-161.

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Abstract: The chronic ulcerative colitis is a relatively common discase in the European and North American countries. In Korea, however this disease is a rare entity, and only a few case reports have been reported. In the past 6 years, we have experienced three cases of chronic ulcerative colitis, which were diagnosed by the histopathological examinations of the resected colon specimens. They were respectively 32 years old male, 34 years old female and 49 years old male. Detailed clinical histories and pathological findings were described on each of these cases. A brief review of literature on this entity was performed.

Histiocytic Medullary Reticulosis -A case report-: ln Sun Kim, Bum Woo Yoem, Sung Hwa Jung, Seung Yong Park; J Pathol Transl Med. 1977;11(2):163-171.

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Abstract: A 30 year old korean male was admitted to Korea University Hospital because of high fever and diarrhea of one week duration. Physical examination discloses left axillary lymphadenopathy and hepatomegaly. The patient was treated for typhoid fever with chloramphenicol and antipyretics and discharged with some improvement of symptoms after 4 days hospital stay. He was readmitted after 10 days with general weakness, weight loss, dyspnea, epistaxis and abdominal distension. Peripheral blood findings included pancytopenia with 2% atypical higtiocytes. On the next day, bone marrow aspiration and left axillary lymph node biopsy were done. However, his conditions deteriorated rapid1y and the patient expired on the third day of the second admission. Autopsy was not performed. The bone marrow smears revealed 14% atypical histiocytes, most of which engaged in phagocytosis of erythrocytes, granulocytes, and platelets. The lymph node disclosed preservation of nodal architectures with infiltrations of atypical histiocytes and their precursors in the subcapsular and medullary sinuses. Phagocytosis of erythrocytes and granulocgtes by more differentiated histiocytes was noted.

Congenital Leukemia -A case report with autopsy findings and literature review-: Sook Hee Hong, Choon Won Kim, Ki Hong Kim; J Pathol Transl Med. 1977;11(2):173-181.

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Abstract: We have experienced a case of congenital leukemia in a six-month-old male child with chief complaints of petechial hemorrhages on whole body surface, mild fever and diarrhea for 3 months before admission to HYUH on 12th, April, 1976. Although the first symptoms are noted at third month after birth, the clinical, hematologic and pathologic findings are consistent with the findings of congenital leukemia. The important findings in autopsy are a diffuse hemorrhage throughout the right ventricular wall of the heart and a focal hemorrhage in the right frontal lobe of the cerebrum, which were thought to be the critical cause of death in this patient. The microscopic findings revealed severe leukemic infiltrations of the liver, heart, kidneys, thymus, lymphnodes, bone marrow, esophagus, stomach, intestine, pancreas and skin as well as vascular engorgements of the cerebrum, cerebellun. midbrain and lungs.

Metastatic Cancer Cells Found in the Routine Bone Marrow Studies -A collective study of 40 cases-: Soo Nam Rhee, Mi Kyung Hur, Sun Moo Kim, Chong Moo Lee; J Pathol Transl Med. 1977;11(2):183-187.

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Abstract: During the 11 years period from Jan. 1, 1966 to Dec. 31, 1976, the authors found 40 cases of metastatic cancer involving the bone marrow among the 2068 cases of routine bone marrow studies. In most cases the routine bone marrow studies included histopathological examination of the hematoxyline and eosin stained tissue sections of the aspirated bone marrow particles as well as microscopic studies of the Wright stained bone marrow smears. On the 40 cases only 4 could be able to confirm histopathologically their primary site of origin. There were one each case of papillary adenocarcinoma of the thyroid, neuroblastoma of bilateral adrenal medulla, hepatocarcinoma and renal cell carcinoma arising from right kidney. The primary site of the remaining 36 cases were not verified histopathologically, though in the bone marrow smeary as well as in the tissue sections metastatic malignant cells (exclusive of leukemia as well as lymphoma cells) were found, and in many of the cases varying degree of clinical accessory data were available to suggest their primary sites. Slight to marked anemia (Table 4) were found in 22 out of 26 cases whose clinical records could be reviewed at the time of this collective study. Leukoerythroblastic blood pictures were founts in 5 out of 40 cases.

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