Journal of Pathology and Translational Medicine

Volume 17(2); September 2006

Reviews

Fine Needle Aspiration Cytology of Lymph Node : Reactive Hyperplasia vs Malignant Lymphoma.: Chan Hwan Kim; Korean J Cytopathol. 2006;17(2):75-78.

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Abstract PDF: No Abstract available.

Fine Needle Aspiration Cytology of Medium to Large Cell Lymphomas of Lymph Node.: Jinman Kim; Korean J Cytopathol. 2006;17(2):79-86.

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Abstract PDF: No Abstract available.

Fine Needle Aspiration Cytology of Non-Hodgkin Lymphomas predominating Small Lymphoid Cells : Differential Diagnosis of Small Lymphoid Cell Neoplasm.: Seung Sook Lee; Korean J Cytopathol. 2006;17(2):87-98.

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Abstract PDF: No Abstract available.

Etc

Morphometric and Histochemical Studies on the Mucosa adjacent to Primary Carcinomas of the Colon and Rectum: Chan Il Park, Tae Seung Kim, Dong Sik Kim; Korean J Cytopathol. 1983;17(2):95-104.

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Abstract: 원발성 대장선암의 조직발생기원을 추구하기 위하여 지난 10여년 간 암병변 주위점막의 변화에 관한 연구가 진행되어 왔으며, 현재까지 기술된 변화들은 crypt에 구조적 변화가 초래된다는 것과 대장점액이 sulfomucin에서 sialomucin으로 바뀐다는 것으로 요약할 수 있다. 실험동물에 DMH를 투여하면 인체 대장암 주위점막에서 볼 수 있는 변화와 유사한 과정을 거쳐서 암이 발생하며, 특히 점액성분의 변화는 일정시기의 태아에서와 같다는 보고들로 미루어 볼 때 이러한 주위점막 변화는 대장암의 전암병변일 가능성이 매우 짙으나 아직도 대장암에 의한 2차적 변화일 가능성이 완전히 배제되지 않고 있다. 이에 저자들은 원발성 대장선암 66예의 주위점막에 대하여 광학현미경적 조직계측과 aldehyde fuchsinalcian blue(pH 2.5) 및 high iron diamine(HID)-alcian blue(pH 2.5)를 이용한 조직점액성분변화를 조사하고 이를 cloacogenic carcinoma, anorectal squamous cell carcinoma, 자궁경부로부터의 전이암, 육종 및 장결핵을 포함한 양성병변들과 비교하였던 바 다음과 같은 결과를 얻었다. 병변으로부터 4㎝ 상부의 점막을 대조점막으로 할 때 원발성 대장선암과 cloacogenic careinoma에서는 주위점막(TM)의 crypt 깊이가 대조점막(CM)보다 각각 1.71배 및 2.12배, crypt 직경이 각각 2.17배 및 2.99배 증가하였으나 기타 질환에서는 TM과 CM간에 뚜렷한 차이를 보이지 않았다. Crypt의 분지도 원발성 선암 66예 중 62예와 cloacogenic carcinoma 2예 모두에서 관찰되었으나 그 외의 병변에서는 이러한 점액성분의 변화를 볼 수 없었다. 이상의 결과로 보아 대장선암 TM의 crypt 구조 및 점액성분 변화는 원발성 대장상피암의 전암병변으로 사료되었으며 원발성 대장암의 조직기원에 있어서 가장 먼저 초래되는 변화는 sialomucin을 함유한 goblet cell 증식이고 이로 인하여 crypt의 구조적 변화가 야기되며, 세포학적 이형성 및 점액의 감소는 그 후에 초래되는 암형성의 과정이라고 추측되었다.

Review

Differential Diagnosis of Fine Needle Aspiration Cytology of Benign Lymphadenopathy.: Eun Mee Han, Dong Eun Song, Dae Un Eom, Hye Jeong Choi, Hee Jeong Cha, Jooryung Huh; Korean J Cytopathol. 2006;17(2):99-107.

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Abstract PDF: In the investigation of superficial lymphadenopathy of unknown cause, fine needle aspiration (FNA) cytology plays an invaluable role. It enables the differentiation of benign lymphadenopathy from lymphoid and non-lymphoid malignancies, obviating the need for open biopsy, and allowing the triage of patients. Cytopathologists should be familiar with the typical FNA patterns of benign lymphadenopathy, and recognize and differentiate among categories. In a minority of cases of benign lymphadenopathy, FNA can render a specific diagnosis. Benign lymphadenopathies are generally categorized into reactive lymphoid hyperplasia (RLH), inflammatory or infectious processes, and benign lymphoproliferative disorders. RLH characteristically presents with a heterogeneous and polymorphous smear composed of normal cellular constituents of lymph nodes, in contrast with the homogeneous or monomorphic smear of most lymphomas. The caveat is that various malignant disorders may also present with polymorphous populations. It is also important to recognize thatbenign lymphoid smears may sometimes contain atypical cells that raise the suspicion of malignancy. Clinical information should always be the integral part of the diagnostic criteria in FNA of lymphadenopathy. If there is any doubt about the benign nature of the smear, it is prudent to suggest biopsy and ancillary studies.

Etc

Antiplatelet Antibodies Detected in Thrombocytopenia with Indirect Platelet Suspension Immunofluorescence Test: Young Joo Cha, Hang Ik Cho, Sang In Kim; Korean J Cytopathol. 1983;17(2):105-111.

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Abstract: Indirect platelet suspension immunofluorescence test was performed in sixty-seven patients with thrombocytopenia. Clinical diagnoses were idiopathic thrombocytopenic purpura (ITP) in 17, multiple transfusion in 16, systemic lupus erythematosus in 8, rheumatoid arthritis in 2, autoimmune hemolytic anemia in 1, malignant lymphoma in 1, multiple myeloma in 1, neonatal thrombocytopenia in 1, and non-immune thrombocytopenia in 20. The results are as follows: 1) Antiplatelet antibodies were positive in 2 of 17 cases with ITP (12%) 2) Of 13 cases with autoimmune thrombocytopenia other than ITP, antiplatelet antibodies could be detected in 4 cases (31%). 3) Antiplatelet antibodies were detected in 5 out of 16 cases with multiple transfusions. HLA antibodies were detected in 3 and platelet-specific antibodies in 2 among 5 cases with positive antinlatelet antibodies. 4) Among 11 cases with positive antiplatelet antibodies, IgG antibodies were detected in 8 (73%), IgM antibodies in (18%), and IgG puls IgM in (9%). 5) In one case of SLE with positive antiplatelet antibody, an increase in platelet count was observed, being antiplatelet antibody negative during therapy with prednisolone. 6) Of 20 cases with non-immune thrombocytopenia, all were negative in indirect platelet suspension immunofluorescence test. On the basis of these findings, it was considered that the indirect platelet suspension immunofluorescence test would be a useful method for detection of platelet autoantibodies and alloantibodies. IgM agglutinins, IgG non-agglutinating antibodies, platelet-specific antibodies, and HLA antibodies were also detectable with this method.

Original Article

The Diagnostic Utility of Mesothelial Markers in Distinguishing between Reactive Mesothelial Cell and Adenocarcinoma Cells in Serous Effusions with Cytospin Preparation.: Sooim Choi, Mi Sun Kang; Korean J Cytopathol. 2006;17(2):108-115.

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Abstract PDF: Evaluation of serous effusions can include immunocytochemical stains that differentiate reactive mesothelial cell from adenocarcinoma cell. Among several positive mesothelial cell markers, we used desmin, CK5/6, WT1 and calretinin all known to have high sensitivity and specificity as selective mesothelial cell markers. We studied smears obtained with cytospin from 15 malignant and eight benign effusions. The mesothelial cells were positively stained by desmin, CK5/6, WT1 and calretinin in 60.9%, 29.1%, 26.7% and 56.5%, respectively among 8 benign and 15 malignant effusions; the adenocarcinoma cells were positively stained 6.7%, 13.3%, 1.0% and 0.0%, respectively among 15 malignant effusions. The percentage of positively stained mesothelial cells were somewhat lower for all antibodies compared to the results of previous studies. This was likely due to the differences in preparation methods and fixatives among studies. In conclusion, the use of desmin and calretinin were more valuable than CK5/6 and WT1 for distinguishing between reactive mesothelial cell and adenocarcinoma cells in serous effusion; however, choice of the proper preparation methods and fixatives are also important

Etc

Koilocytotic Atypia and Cervical Neoplasia: Hye Yeon Kim, In Sun Kim, Seung Yong Paik; Korean J Cytopathol. 1983;17(2):112-118.

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Abstract: The concept of koilocytotic atypia of the cervix was defined and developed by Koss although the morphologic alterations were described previously by others. The koilocytotic atypia and squamous cell carcinoma frequently coexist and their histologic features sometimes merge imperceptibly. In the author's study, forty-five hysterectomized specimens were obtained for cervical squamous cell carcinoma to determined the association of the koilocytotic atypia with cervical malignancy. Forty-five controls were selected from patients who were underwent hysterectomy for uterine leiomyomas. According to a blind semiobjective scoring system of the Reid, the results are as follows: 1) The major histologic features of the neoplastic group were koilocytotic cytoplasmic vacuolization (98%), basal cell hyperplasia (98%), binucleation (96%) and dyskeratosis (93%). But stromal changes were not significant. Those of the control group were basal cell hyperplasia (31%), koilocytotic nuclear changes (13%) and acanthosis (13%). 2) Forty-three of 45 women (95.6%) showed histologic evidence of hyman papillomavirus infection. Forty-three of the controls, but none of the neoplastic group, had normal cervical epithelium. As a result, it was evident that there is association of koilocytotic atypia and cervical malignancy.

Original Article

Morphometric Analysis for Cytological Diagnosis of Thyroid Papillary Carcinoma.: Jong Ok Kim, Bo Seong Yang, Hye Soo Kim, Jong Min Lee, Dong Ho Lee, So Young Shin, Chang Suk Kang, Hye Kyung Lee; Korean J Cytopathol. 2006;17(2):116-119.

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Abstract PDF: The diagnosis of papillary thyroid cancer is generally based on the findings of intranuclear cytoplasmic inclusions and nuclear grooves. Although anisokaryosis and poikilokaryosis, in papillary thyroid cancer, are not distinct when compared to other cancers, cytological examination can provide useful preoperative information. Our study evaluated the diagnostic role of computer-assisted image analysis for the pre-surgical assessment of papillary thyroid carcinoma. Thyroid aspirates from twenty female patients who were histologically confirmed to have both papillary carcinoma and benign nodules were studied. Different populations of 50 benign cells and 50 malignant cells were analyzed. Five morphometric parameters were selected for analysis: nuclear area, perimeter, maximum length, maximum width and intensity standard variation. The values obtained for papillary carcinomas were higher than the surrounding benign nodules as follows: nuclear area 63.5 vs. 36.1 (p=0.000), nuclear perimeter were 29.4 vs. 22.0 (p=0.000), maximum length 9.6 vs. 7.1 (p=0.000), maximum width 8.2 vs. 6.3 (p=0.000), the ratio between maximal length and maximal width 1.16 vs. 1.13 (p=0.000), the standard variation of intensity 14.9 vs. 15.9 (p=0.101) respectively. Therefore, morphometric information can be helpful for the differential cytological diagnosis of papillary thyroid carcinoma.

Etc

Studies on β-Glucuronidase Activity in the Rats with Clonorchiasis: Yeon Jae Cheong, Sun Kyung Lee; Korean J Cytopathol. 1983;17(2):119-126.

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Abstract: This study was performed in order to investigate the changes of β-glucuronidase activity in rats with clonorchiansis. The rats were experimentally infested with 200 metacercariae of Clonorchis sinesis. The metacercariae were isolated from the Pseudorasbora parva by digestion technique. The animals were killed by a depletion of blood at 1st, 2nd 3rd and 4th week after infestation; the livers and blood in the heart were obtained and examined immediately for the enzyme activity. The livers were also examined morphologically. The results obtained were summarized as follows; 1) Marked papillary and adenomatous hyperplasia of bile ducts and acute and chronic inflammatory reaction of the portal areas were observed in the liver of rats with clonorchiasis. The hyperplasia of bile ducts was somewhat more severe as the days go by. 2) β-glucuronidase activities in the liver and serum were significantly increased form first to fourth week after infestation compared to the findings of control animals. 3) There was a positive correlation between β-glucuronidase activities in the liver tissue and serum. On the basis of the above findings, it was suggested that Clonorchis sinensis is a continuously increasing factor of β-glucuronidase activity in the liver and serum, and that there is a correlation between increase of β-glucuronidase activity and hyperplasia of intrahepatic bile ducts.

Original Articles

Differential Diagnosis between Small Cell Carcinoma and Adenocarcinoma of Lung in Fine Needle Aspiration Cytology.: Young Hee Choi, Jae Soo Koh, Sunhoo Park, Min Suk Kim, Soo Youn Cho, Jung Soon Kim, Hwa Jung Ha, Seung Sook Lee; Korean J Cytopathol. 2006;17(2):120-125.

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Abstract PDF: Distinguishing small cell carcinoma from other lung malignancies is of great clinico-therapeutic significance. Small cell carcinoma is an aggressive tumor with a tendency to metastasize early. Survival time if untreated is low but this tumor is highly responsive to chemotherapy. We have occasionally experienced difficulties in differentiation between adenocarcinoma and small cell carcinoma of the lung in fine needle aspiration cytology (FNAC). The aim of this study was to investigate the possibility of distinguishing small cell carcinoma from adenocarcinoma of the lung in FNAC. We evaluated cytomorphological features of FNAC specimens from 62 small cell carcinomas and 57 adenocarcinomas from the lung that were confirmed by biopsy and/or immunohistochemistry on cell block. Cytomorphological details of the two tumors were compared. Nuclear smearing and nearly absent cytoplasm were the most distinct findings in small cell carcinoma compared to adenocarcinoma (p<0.05). Necrotic background, architecture and chromatin pattern, nuclear molding and nucleoli were significantly different (p<0.05). Nuclear size, nuclear membrane nature and nuclear size variation however were not helpful in distinguishing the two tumors. Combining several features described above, small cell carcinoma can be properly differentiated from adenocarcinoma on FNAC. FNAC is proposed as a diagnostic tool of small cell carcinoma of the lung in the case of inaccessibility to biopsy, and so may allow the proper therapeutic strategies to be determined in such cases.

Cytomorphologic Comparison of Hodgkin Lymphoma and Anaplastic Large cell Lymphoma in Fine Needle Aspiration Cytology.: Seung Sook Lee, Jae Soo Koh, Sunhoo Park, Min Suk Kim, Soo Youn Cho, Soo Young Chung, Han Suk Ryu, Jung Soon Kim, Hwa Jung Ha, Baek Youl Ryoo; Korean J Cytopathol. 2006;17(2):126-135.

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Abstract PDF: To study the differentiating cytomorphological features of Hodgkin lymphoma (HL) and anaplastic large cell lymphoma (ALCL) using fine needle aspiration cytology (FNAC), cytomorphological features of 16 patients with HL (n=8) or ALCL (n=8) were analyzed. In the initial cytological diagnosis prior to biopsy, HLs were properly diagnosed in 4 out of 8 cases (4 HL, 2 atypical, 2 benign), whereas all ALCL were diagnosed as malignancies. However, correct diagnosis of non-Hodgkin lymphoma (NHL) was made in only two ALCL patients (2 NHL, 1 HL, 1 sarcoma, 4 malignancy without specific type). Overall, the percentage of large abnormal cells ranged from 30% to 90% in ALCL except for one case, whereas it was less than 5% in all 8 HL. A spectrum of atypical cells was more characteristic of ALCL. In contrast, HL showed an sharp difference between reactive lymphoid cells and neoplastic ones (bimorphic pattern). Moreover, the emergence of kidney-shaped abnormal cells or wreath-like multinucleated cells was helpful in diagnosing ALCL. The combination of thesefeatures would be useful in differentiating HL and ALCL. Nevertheless, these two types of lymphomas cannot be definitely distinguished based on cytomorphological features alone. Therefore, the aim of FNAC would be to suggest a specific diagnosis and indicate the need for a biopsy.

Etc

Cardiac Conduction System -Morphologic observations on the autopsy cases-: Jeong Wook Seo, Je GeunChi, Sang Kook Lee; Korean J Cytopathol. 1983;17(2):127-137.

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Abstract: Sinoatrial (S-A) nodes and atrioventricular (A-V) nodes of 13 human hearts were examined by regular step sections and morphometry. Eleven cases were from fetuses, infants and children, and the others were from adult cases. S-A nodes were examined in 3 ways. The first one was resection, horizontal trisection and regular step sections by 100 micrometers. The second one was resection, longitudinal bisection and regular step sections, and the third one was regular step section in toto. Fifty sections were obtained from each node, and length of tissue in paraffin block was calculated from the total count of sections. Location, area and volume of S-A nodes were measured and corrected. The major sources of errors were contraction during formalin fixation, contraction during dehydration and paraffin embedding, and irregular change of length during microtoming. The latter two were corrected by use of total section count and measurement of length of paraffin on slide. The following results were obtained. 1) S-A node is located at one fourth (26.8/100) of the length of sulcus terminalis, below the summit of atrial auricle. S-A node is located at subepicardium of sulcus terminalis. (Crista terminalis is at some distance.) 2) Relative range of S-A node is 16.8/100 of the length of sulcus terminalis. And it decreases as cardiac weight increases. Relative volume of S-A node is 1/20,000 of the volume of heart. And it decreases as cardiac weight increases. 3) S-A node is located at the right atrial subendocardium, at some distance above the center of tricuspid septal leaflet. The node runs antero-inferiorly to the His bundle and pierces the cardiac skeleton.

Case Report

Cytologic Features of Villoglandular Adenocarcinoma of the Uterine Cervix : A Report of Two Cases.: Bohng Hee Kim; Korean J Cytopathol. 2006;17(2):136-142.

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Abstract PDF: Villoglandular adenocarcinoma of uterine cervix has recently been described, and is characterized by good prognosis and occurrence in young women, except a small number of cases. Morphologically, it exclusively shows villoglandular growth and mild to moderate nuclear atypia, the cytologic diagnoses have been frequently missed due to interpretation error. We report here on the cytologic findings of two cases, and both cases were not diagnosed as adenocarcinoma before punch biopsy. One of these cases showed previously described characteristic features such as high cellularity and large tissue fragments with long villous fronds lined by columnar cell with mild nuclear atypia. The other showed moderate cellularity of somewhat smaller clusters without long villous structures. The clusters showed marked nuclear overlapping and the nuclei showed distinct moderate atypia with hyperchromasia and coarse chromatin pattern. The nucleoli were indistinct. Recognition of these features will be helpful to avoid underdiagnosis as a benign lesion, although diagnosis is still difficult in a portion of the cases.

Etc

Histopathologic Study on Hodgkin's Disease: Sung Sik Shin, Je G Chi, Sang Kook Lee; Korean J Cytopathol. 1983;17(2):138-143.

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Abstract: A total of 42 cases of Hodgkin's disease was obtained from the file of Department of Pathology, College of Medicine, Seoul National University during a period of 7 years from 1976 to 1982. These cases were critically reviewed microscopically and classified according to Rye modification of Lukes-Butler classification. In 42 cases of Hodgkin's disease the patients ranged in age from 5 to 75 years, with an average of 35.1 years. Male to female ratio was 5:1. Histological types consisted of 17(40.5%) mixed cellularity, 12 (28.6%) lymphocyte depletion, 7 (16.6%) lymphocyte predominance and 6 (14.3%) nodular sclerosis. Biopsy sites were lymph nodes in 36 cases, spleen in 2 and gastrointestinal tract in 4. Comparing with previously reported material on non-Hodgkin's lymphoma in our department, there were 25 cases of Hodgkin's disease and 160 cases of non-Hodgkin's disease comprised 13.5% of all malignant lymphoms. In conclusion, Hodgkin's disease in Korea seems to be characterized by relatively low incidence comparing with non-Hodgkin's lymphoma, and low relative frequency of nodular sclerosis type, while lymphocyte depletion type is relatively high.

Case Report

Touch Imprint Cytology Contributed to the Frozen Section Diagnosis of Merkel Cell Carcinoma : A Case Report.: Changyoung Yoo, Youn Soo Lee, Joo Wan Park, Suk Kang Chang, Sang In Shim, Gyeong Sin Park, Kyo Young Lee; Korean J Cytopathol. 2006;17(2):143-147.

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Abstract PDF: Merkel cell carcinoma (MCC), a rare primary cutaneous small cell neuroendocrine carcinoma, is a tumor with distinct cytological features. In many cases, immunohistochemical staining (IHC) is required for the differentiation from other small round cell malignancies. Here we describe the cytological findings of Merkel cell carcinoma; these findings contributed to the diagnosis prior to performing IHC. A lower eyelid mass was excised and submitted for frozen section diagnosis. The frozen section diagnosis was consistent with a malignancy, but the more specific diagnosis was limited by the lack of specific histological features. Touch imprint cytology revealed a high cellularity with loosely cohesive small to large sized cells. The tumor cells showed hyperchromatic nuclei with fine chromatin and inconspicuous nucleoli, and thin-rimmed-cytoplasm including the characteristic eosinophilic button-like paranuclear inclusion, previously described as a pathognomonic cytological finding of MCC; this was not found in the H&E frozen section. In conclusion, we suggest that the touch imprint cytology may help in the differential diagnosis of small round cell neoplasms prior to performing IHC especially in frozen section diagnosis.

Etc

Sézary Syndrome: Hyung Sik Shin, Chang Sik Shin*, Seong Hoe Park, Eil Soo Lee*; Korean J Cytopathol. 1983;17(2):144-152.

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Abstract: Sézary syndrome was first described in 1983, by Sézary and Bouvrain. The classical description of this syndrome consist of generalized pruritus, exfoliative dermtitis with edema and thickening of the skin, ectropion, leonine facies, alopecia, dystrophic nails, keratoderma of the palms and soles, and lymphadenopathy associated with leukocytosis and abnormal mononuclear cells. We present a case of Sézary syndrome, in a 50-year-old male farmer with generalized exfoliative erythroderma, keratoderma of palms and soles, generalized lymphadenopathy, hepatomegaly, and pruritus, as clinical features, and severe leukocytosis (W.B.C.: 66.000㎣ of blood) with increased atypical mononuclear cells (21,120/㎣ of blood) in the peripheral blood, of which most were identified as cerebriform mononuclear cells with electromicroscopy as hematologic features. Histopathologic findings of the skin lesions revealed hyperkeratosis with parakeratosis and slight acanthosis of epidermis, moderate to marked mononuclear cells mixed with a few atypical cells in the papillary and upper dermis with epidermotropism. Axillary lymph node biopsy findings showed loss of normal architecture and marked infiltration of mononuclear cells with many atypical cells. Chemotherapy with vincristine, cyclophosphamide, adriamycin, bleomycin, and prednisolone, was done. Two weeks later, the exfoliative erythrodermic lesion and pruritus were nearly subsided and a few atypical lymphocytes (504/㎣) were observed in peripheral blood smear.

Case Reports

The Cytology of a Cellular Variant of Cerebellar Hemangioblastoma in Squash Preparation : Pitfalls in Diagnosis.: Young Lyun Oh, Yeon Lim Suh; Korean J Cytopathol. 2006;17(2):148-152.

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Abstract PDF: Due to its nuclear pleomorphism, knowledge regarding the cytological findings of cerebellar hemangioblastoma can lead to misdiagnosis when using squash specimens, which in other circumstances serves as a useful adjunct in the diagnosis of brain tumors on frozen section. We recently experienced the cytological findings of a cellular variant of cerebellar hemangioblastoma in a 51-year-old man. Squash specimens revealed scattered single tumor cells, with pleomorphic nuclei and cytoplasmic vacuoles, on a hemorrhagic background. The cellular clusters were composed of spindle-shaped endothelial cellsin addition to densely clustered stromal cells. Intranuclear inclusions were frequently seen. The nuclear pleomorphism, bubbly cytoplasmic vacuoles and presence of intranuclear inclusions, seen in the squash specimen, may increase the difficulty of frozen section diagnosis of cerebellar hemangioblastoma. Awareness of the cytologicalfindings of hemangioblastoma is needed to avoid the pitfalls in the intraoperative diagnosis of cerebellar hemangioblastomas.

Cytological Features of Low Grade Fibromyxoid Sarcoma : Report of a Case with a Review of the Literature.: Mi Seon Kwon; Korean J Cytopathol. 2006;17(2):153-158.

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Abstract PDF: Low-grade fibromyxoid sarcoma (LGFMS) is a rare soft tissue tumor. There have been only a few prior fine-needle aspiration (FNA) cytological reports. Recognition of this tumor is important because of its potential for metastasis despite its indolent nature and its deceptively bland cytologic appearance. A 60-year-old male presented with a slowly growing mass in the left calf detected 10 years ago. The patient underwent surgical excision. FNA cytology was performed directly on the mass. The smears showed low cellularity composed of hypercellular tissue fragments, hypocellular loose aggregates, and stripped nuclei. The cytoplasm was seen as either collagenous material or very thin fibrillary collagen strands. Tumor cells had spindle, ovoid, or irregular nuclei, fine chromatin, and small nucleoli. Focally slight degree of nuclear pleomorphism is noted. There were no mitotic figures. Blood vessels were frequently seen. Immunocytochemically, tumor cells were negative for S-100 protein, desmin, smooth muscle actin, and CD34. The diagnosis of LGFMS is rarely possible by cytology alone; however, LGFMS should be included in the differential diagnosis of spindle-cell tumors consisting of hypercellular and hypocellular components with some capillary-sized vessels arising in the deep soft tissue of the lower extremities, particularly the thigh. The immunocytochemical findings are of help in the differential diagnosis.

Etcs

A Case of Weak Blood Group B Expression: Mi Young Park, Kyung Soon Song, Samuel Y. Lee; Korean J Cytopathol. 1983;17(2):153-155.

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Abstract: Weakened forms of the B antigen was first discovered by Moullec in 1955. Common causes for these findings are due to rare alleles at the ABO locus, action of other genes on normal ABO genes, or environmental variations such as weakening of A and B antigens in leukemia & acquired antigens as a result of infection. Weak B activity due to acquired B antigen phenomenon is known to be found only in A1 person. These acquired variations of B are manifested secondary to the bacterial infection, malignancy, and aging. A 43-yr-old female patient who was once blood typed as O, had weak B antigen with cold reacting anti-B in her sera. It was thought to be as rare B type subgroup although some other possibilities of acquired B antigen could not be ruled out.

Light Chain Disease, Lamda Type -A case report-: Kyung Ja Han, Won Il Kim, Sun Moo Kim, Chong Moo Lee; Korean J Cytopathol. 1983;17(2):156-159.

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Abstract: Light chain disease is a type of multiple myeloma. Its clinical manifestation and bone marrow features are similar to those of other myelomas, but its prognosis is poorer than others. The authors have experienced a case of light chain disease by the electrophoresis and immunoelectrophoresis of the serum and urine and bone marrow biopsy with immunoperoxidase staining. This is a report of the case with clinical history and laboratory studies. A brief review of literature is added.

Case Report

Fine Needle Aspiration Cytological Findings of Angioimmunoblastic T-cell Lymphoma : A Brief Case Report.: Ji Han Jung, Hyun Joo Choi, Jinyoung Yoo, Seok Jin Kang, Chang Suk Kang, Kyo Young Lee; Korean J Cytopathol. 2006;17(2):159-161.

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Abstract PDF: Recently, we experienced a case of Angioimmunoblastic T-cell lymphom (AITL) in a 60-year-old man presented with lymphadenopathy, which is first cytological report in Korea. The cytological features showed a heterogeneous population of small to medium-sized lymphocytes, immunoblasts, and plasma cells. Characteristically, there were also a distinct population of follicular dendritic cells admixed with lymphoid cells, forming the so-called dendritic cell-lymphocyte complexes. Histological features showed the classic morphologic features of AITL. Recognition of the characteristic cytological features can suggest the possibility of AITL.

Etcs

A Case Report of Myxoid Leiomyosarcoma of the Uterus: Han Kyeom Kim, Jong Sang Choi, Seung Yong Paik, Myung Seo Kim*; Korean J Cytopathol. 1983;17(2):160-164.

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Abstract: Although myxoid change is known to occur in smooth muscle tumors of benign or unspecified nature, leiomyosarcomas have rarely been mentioned in differential diagnosis of sarcomas with myxoid features. To date about six cases have been reported in the literature. This case report is of a 51-year-old woman whose uterus was found to contain a submucosal polypoid mass of myxoid leiomyosarcoma. It is believed to be the first recorded case of myxoid leiomyosarcoma of the uterus in Korea. Grossly, the uterine cavity was filled with a large polypoid mass originating from right lateral wall of fundus. The mass was 5×2.5m in cross and characterized by a gelatinous appearance and an apparently circumscribed border. On microscopical examination, However, it was observed to invade adjacent myometrium and contained copious amounts of myxomatous stroma. Although it was difficult to establish the nature of the neoplastic cells in some areas of these tumor, both light microscopial and histochemical examination showed characteristic features of smooth muscle cells in other areas. The mitotic count was 9/10 high-power-fields. The reported cases of myxoid leiomyosarcoma were those of recurrent lesions within 6 months to 10 years after surgical resection and had average mitotic numbers of 0-2/10HPF. To diagnose this case, mitotic count of 9/10HPF was helpful.

Double Outlet Right Ventricle, Taussing-Bing Type -An autopsy case-: Jeong wook Seo, Je G. Chi, In Aee Park, Sang Kook Lee, Yong Soo Yoon*, Sei Woen Yang*; Korean J Cytopathol. 1983;17(2):165-170.

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Abstract: 이중 유출로 우심실은 1957년 Witham에 의해 명명된 기형으로 대동맥과 폐동맥이 모두 우심실에서 나가는 심장기형군이다. 이 기형은 대동맥, 폐동맥 및 심실중격결손의 상호관계에서 여러 가지 변형을 보이기 때문에 그에 따라 임상소견도 다양하고 유사 심장기형과의 감별이 어려우며 그 정의 자체도 학자에 따라 이견을 보이고 있다. 저자들은 생후 20개월만에 사망한 남자아기에서 Taussing-Bing 형으로 생각되는 이중유출로 우심실을 부검하여 보고한다. 정상분만으로 태어난 이 아기는 출생시부터 청색증과 호흡곤란이 있었다. 머리가 점점 커져 수두증을 생각하고 뇌압을 낮추기 위한 뇌실-복강 연결관을 시술하였다. 수술에 의한 합병증으로 사망하였다. 흉부 방사선 촬영상 심장종대와 폐혈관 증가가 있었고 심전도상 우심방 및 우심실 비대가 있었다. 부검시 심장은 커져 있었다(119gm). 특히 우심실 비후가 현저하였다. 대동맥은 폐동맥의 우측 전방에 위치하였고 대동맥하 conus가 있어 삼첨판 및 승모판과의 연결이 없었다. 폐동맥은 정상위치에 있었다. 폐동맥하 심실중격결손이 있었고 그 결손을 통하여 폐동맥 판막과 승모판이 섬유성으로 연결되어 있었다. 좌측 관상동맥이 폐동맥 전방으로 주행하였다. 뇌의 부검소견은 연결형 수두증으로 양측 측뇌실과 제3뇌실의 심한 확장이 있었고 화농성 염증이 심하였다. 본례의 심장은 대동맥하 conus는 발달되어 있으나 폐동맥 판막과 승모판이 섬유성 연결을 보이기 때문에 이런 기형을 이중 유출로 우심실에 넣기도 하지만 학자에 따라서는 대동맥 전위증 혹은 그들의 중간형으로 분류하기도 한다. 저자들은 이중 유출로 우심실에서 대동맥과 승모판의 연결은 없어야 하지만 대동맥과 삼첨판 혹은 폐동맥과 승모판의 연결은 있어도 좋다고 생각하였고 아울러 이러한 형태학적 확인이 없이는 진단하기 어려운 기형이라고 생각하였다.

Alveolar Soft Part Sarcoma -A case report-: Chul Woo Kim, Sung Ho Lee, Ik Won Kang*, Je G. Chi**; Korean J Cytopathol. 1983;17(2):171-173.

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Abstract: A case of alveolar soft part sarcoma accurring in the abdominal wall in a 28 year old woman is reported. The mass was slowly growing during past 5 years to become hen egg sized. The lesion was suggested for a sort of malignant vascular neoplasm, clinically, on the basis of preoperative arteriographic findings, showing highly vascularized irregular mass fed by the right deep circumflexiliac artery with subsequent rapid venous drainage of pooled blood. Grossly, the mass was firm and measured 4.5×4.0×2.5㎝. The tumor was relatively well circumscribed except for areas where it blended into surrounding skeletal muscle. Cut surface showed pinkish gray in color with multifocal hemorrhagic microcystic appearances. Microscopically, tumor showed organoid arrangement of lobules separated by numerous delicate vascular septa. Individual tumor cell contained P.A.S. positive crystalline granules in the cytoplasm and prominent nucleolus. Brief comments on the histogenesis of this tumor, especially in relation to the vascular smooth muscle cell are made.

Persistent Hyperplastic Primary Vitreous -A report of a case associated with microphthalmia-: Je G. Chi, In Ae Park; Korean J Cytopathol. 1983;17(2):174-176.

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Abstract: 10개월 남아의 오른쪽 소안구를 검색한 결과 일차성 Vitreous의 잔종증이라고 생각되는 소견이 나타났는데 안구는 13×10×10㎜였고, 각막은 6×5㎜였다. 현미경적으로 렌즈의 석회화와 편위, 전방의 기형과 더불어 전반적 망막박리가 있었다. 한편 Vitreous 내에서는 렌즈뒤로부터 시신경 출구에 이르는 hyaloid 혈관과 함께 이형성 망막조직의 증식이 있었고, 이와 더불어 성숙 지방 조직도 그속에 포함되어 있었다.

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