Journal of Pathology and Translational Medicine

A Study of beta-glucuronidase and Lactic Dehydrogenace Activities in the Neoplastic Tissue of Stomach Carcinoma.: Hee Kyung Chang, Sun Kyung Lee; J Pathol Transl Med. 1985;19(2):141-149.

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Abstract PDF: To observe whether the measurement of enzyme activity has any critical role in assesment of diagnostic value, beta-glucuronidase and lactic dehydrogenase activities in neoplastic tissue of stomach were compared with those in the stomach at the stomach mucosa at the antrum and body which was uninvolved by tumor. And then activities of those enzymes were also compared with differentiated and undifferentiated carcinomas. The stomach tested were obtained by gastrectomy in Pusan National University Hospital during the months from March to June in 1983. The results were summarized as follows: 1) beta-glucuronidase activity in the neoplastic tissue of stomach was higher than that in the antral and body mucosa, and this enzyme activity in the antral mucosa with intestinal metaplasia was higher than that in the body mucosa of stomach. 2) Lactic dehydrogenase activity in the neoplastic tissue of stomach was similar to that in the antral mucosa with intestinal metaplasia, and was higher than that in the body mucosa of stomach. 3) Acitivities of both enzymes in the neoplastic tissue of differentiated carcinoma were slightly higher than that of undifferentiated one, but did not found statistically significant difference. 4) In the neoplastic tissue of the stomach there was no significant correlation between beta-glucuronidase and latic dehydrogenase activities. Above results support that the measurement of gastric juice enzymes is useful in the diagnosis of stomach carcinoma and may be of value in the identification of high-risk groups.

An Experimental Study on the Influence of DDVP upon the Kidney.: Kyo Suck Woo, Chong Man Kim, Kook Hwae Koo; J Pathol Transl Med. 1985;19(2):150-155.

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Abstract PDF: With the progress of farming and foresting, the demand of agricultural pesticide has been remarkably increased and accordingly, its intoxication has been widely publicized. Among the pesticides, organophosphorus chemicals has been believed to be almost nontoxic because they are not accumulative in the tissue. This study is attempted to examine the effects of DDVP which has been used most frequently on the kidney. And they were divided into normal and experimental groups. The results obtained from this experiment are as follows. 1) BUN, serum creatinine are increased in the group of DDVP administered while serum cholinesterase is suppresed significantly. 2) Microscopically, swelling and degeneration of tubular cells and hyaline casts in tubules. Ultrastructually swelling of mitochondria, partial fragmentation of cristae and electron dense bodies in the kidney are observed in the group of DDVP administered.

Chronological Observation on Tissue Reaction to Silk Sutures.: Yoon Seong Lee; J Pathol Transl Med. 1985;19(2):156-159.

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Abstract PDF: Silk is one of the most common sutures in surgical operations, because it is easy to handle and apply the proper tension in tissues. It produces little but appreceable foreign body reaction, when applied in tissues. With 38 tissues from cases of vasovasostomy, who had different time lapsed, the chronological reaction of tissues are made in four stages. It can be a guide for the determination when a silk suture is introduced in tissue. And, there is a general agreement in that, though silk is classified as non-absorbable, it is fragmented and absorbed during a period of years. However, four case over 7 years, where the silk filaments maintain their shape and are still shining, are observed.

Morphologic Study on the Mesothelial Hyperplasia in the Rat.: Chan Choi, Min Cheol Lee, Kyu Hyuk Cho; J Pathol Transl Med. 1985;19(2):160-167.

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Abstract PDF: Reactive mesothelial cells are frequently found in the smear, of body fludid dffusion when associated with liver cirrhosis, pulmonary tuberculosis, congestive heart failure or pulmonary infarction. But it is not easy to differentiate these reactive mesothelial cells from macrophages or various types of malignant cells. In order to investigate the morphology of hyperplastic mesothelial cells, in comparison with the various types of malignant cells in the effusion, this experiment was designed. The tissue reaction was evoked by intraperitoneal injection of 2.5 ml of 2% Talcum suspension. The results obtained were as follows: 1) On light microscopic observation of the tissure, until 5 days, cytoplasm and nucleus of mesothelial cells became larger and nucleoi became prominent. After then, cytoplasm and nucleus became smaller and at 28 days after injection of Talcum suspension, cellular features became similar to those of normal ones. 2) On cytologic observation of touch print specimens, hyperplastic mesothelial cells became round to oval, and their cytoplasm became conspicuous. Nuclei were vesicular, and nucleoi were prominent. N/C ratio was decreased than normal. 3) On electron microscopic observation, hyperplastic mesothelial cells did not have microvilli, but had a few cytoplasmic globular projections, loosely approximated cellular junctions, larger and more abundant intracytoplaomic vesicles when compared with normal one. Chromatin clumping, irregular thickening of nuclear membrane and prominent nucleoi were also noted.

Clinical Application of EMA, CEA and LCA in Differential Diagnosis of Tumors.: Mee Ja Park, Insun Kim, Seung Yong Paik; J Pathol Transl Med. 1985;19(2):168-178.

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Abstract PDF: To determine the therapeutic plan and to predict the prognosis, it is a pivotal and important task to differentiate the exact nature of the various undifferentiated neoplasms. In order to solve this problem, the electron microscopy has once been considered only method in certain cases. Recently, however, the immunoperoxidase staining method which is less expensive and easier to usethan electron microscopy has been developed and introduced. To evaluate the diagnostic value of epithelial membrane antigen(EMA), carcinoembryonic antigen(CEA) and leukocyte common antigen(LCA) immunoperoxidase method, the authors applied these staining in 15 cases of which exact diagnoses were difficult with conventional routine and special stains, using the formalin-fixed and paraffin-embedded tissue sections. The results are as follows: 1) EMA was helpful in confirming the diagnosis or revising to the proper diagnosis of undifferentiated carcinoma in 4 of 6 cases and in excluding the possibility of hepatocellular carcinoma and melanoma in 2 cases, respectively. The negative stainabilities in one case of choriocarcinoma and one case of malignant fibrous histiocytoma was useful to exclude the possibility of squamous cell carcinoma and the positive stainability in one case of giant cell carcinoma to exclude the possibility of sarcoma. 2) The diagnostic value of CEA was similar to that of EMA; CEA was useful to differentiate from malignant lymphoma in one case of epithelial tumor in which CEA was positive and EMA negative. 3) LCA was useful to differentiate one case of malignant lymphoma from undifferentiated carcinoma and to confirm Ewing's sarcoma from malignant lymphoma in one case.

A Study of Vascular Changes in the Lymph Nodes.: Hye Suk Song, Ho Won Hwang, Chae Hong Suh; J Pathol Transl Med. 1985;19(2):179-186.

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Abstract PDF: A retrospective morphological study was conducted on 1677 lymph nodes which were removed surgically under the diagnosis of gastric carcinoma, breast carcinoma, colonic carcinoma, chronic gastric ulcer, and superficial lymph nodes nuder the diagnosis of reactive follicular hyperplasia at Chosun University Hospital during a period of 5 years from 1980 to 1984. The hematoxylin and eosin stained sections were examined to evaluate for any vascular changes. In selected cases further levels were prepared from the paraffin blocks for Gomori's reticulin stain. The vascular abnormalities were divided into 3 groups, such as hemangiomatoid, pan-nodal vasodilatation and miscellaneous types. The miscellaneous type included the proliferation of smooth muscle which encircled numerous small hilar arteries and veins. The results obtained were as follows: 1) The hemangiomatoid lesions were localized lesions which appeared to be associated with local malignancy, but infrequent in incidence. 2) A more frequent vascular abnormality was pan-nodal vasodilatation, which tend to affect many nodes in a single group and is relatively associated with chronic gastric ulcer. 3) Miscellaneous lesion was nonspecific and appeared both local malignancy and chronic inflammation. 4) All three vascular reactions were somewhat more frequent in female than male.

Foreign Bodies in Surgical Tissue Section.: Yoon Seong Lee, Je G Chi; J Pathol Transl Med. 1985;19(2):187-193.

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Abstract PDF: Foreign body reaction of tissues is frequently encountered in routine surgical pathology, whether they contain foreign body or not. Though their presence or identification may be the important clue for the legal problems as in malpractice, and the identification of foreign body will give us the chance for reconstruction of patients' medical history, pathologists often overlook or neglect what they are. Besides curiosity, the description of individual foreign body and common site for its occurence will be of great help. Therefore, we classify and describe the features of 182 foreign bodies collected in practice of surgical pathology during 1979~82.

Metastatic Giant Cell Carcinoma of Thyroid Simulating Primary Small Intestinal Tumor: Report of a case with ultrastrucutral and immunohistochemical studies.: Woo Ho Kim, Yong Il Kim, Seong Hoe Park, Jae Gahb Park; J Pathol Transl Med. 1985;19(2):194-201.

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Abstract PDF: We present a case of metastatic giant cell carcinoma of the thyroid in small intestine presenting as an unusual polypoid growth, and its ultrastructure and immunohistochemical reaction to thyroglobulin were investigated. The patient was a 63 years old female who received a segmental resection of ileum for intestinal obstruction, one year after a radical neck dissection and thyroidectomy for anaplastic (giant cell variant) carcinoma with a focus of papillary tumor of the thyroid. In the segmentally resected ileum, there were three conglomerated round intraluminal polypoid tumor masses in close approximation which measured 4.5 cm, 2.5 cm and 2 cm respectively. The histological features were similar to those of thyroid lesion, being predominantly made of anaplastic giant and spindle cells in haphazard arrangement. Ultrastructure of pleomorphic spindle cells and multinucleated giant cells demonstrated numerous mitochondria with tubular cristae, rough endoplasmic reticula and a few membrane-bound dense granules. Peroxidase-antiperoxidase method against thyroglobulin revealed strong positive staining on papillary carcinoma and weak positivity on both giant cells and spindle cells of the anaplastic carcinoma. The above observations confirm that multinucleated giant cells of small intestine originate from metastatic giant cell carcinoma of the thyroid.

Fibrous Hamartoma of Infancy: Report of three cases.: Eun Hee Suh, Kyung Ja Cho, Geung Hwan Ahn, Je Geun Chi; J Pathol Transl Med. 1985;19(2):202-206.

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Abstract PDF: Fibrous hamartoma of infancy is a distinct clinicopathologic entity with unique microscopic findings and benign clinical course. This tumor is composed of intervening dense fibrocollagenous trabeculae, well defined mucoid areas and varying amounts of mature fat, which are arranged in organoid growth pattern. We report three typical cases of this tumor which were experienced during the recent two years at the Seoul National University Hospital. It is the first description on this tumor in Korean literature. Case 1 was a 10 month old boy who was admitted due to a mass in the right infra clavicular area for 6 months. The mass showed irregular and poorly circumscribed outer surface. Case 2 was a one month old girl who was presented with a diffuse ill defined hairy mass in the left buttock since birth. Case 3 was a 15 month old boy who was brought to the hospital due to well circumscribed scrotal mass fot 8 months. Microscopically all three cases showed very similar histological features. And all 3 cases are well after the removal of the tumors.

Burkitt's Lymphoma Developed Acute Leukemia: A report of two cases.: Young Dae Kim, Kyoung Ja Han, Byoung Kee Kim, Sun Moo Kim; J Pathol Transl Med. 1985;19(2):207-213.

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Abstract PDF: Burkitt's lymphoma with a frankly leukemic picture is an extremely rare condition, and usually has a very acute course with a poor prognosis. The authors experienced two cases of Burkitt's lymphoma developed acute leukemia. The first case was 8 years-old boy who had rapidly growing large abdominal mass, which revealed typical Burkitt's lymphoma with characteristic "starrysky" pattern. The second case was 20 year old male who had not definite tumor mass. Their peripheral blood and bone marrow aspiration revealed acute leukemia with multiple vacuolated lymphoblast of Burkitt's type. We report these cases with brief review of literatures.

Malignant Transformation in Cystic Teratoma of Ovary: 4 cases report.: Seong Sook Kim, Ae Lan Paik, Hye Je Cho, In Ki Paik, Ill Hyang Ko; J Pathol Transl Med. 1985;19(2):214-219.

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Abstract PDF: Development of a malignant tumor within a mature cystic teratoma is a serious event, and occurs in about 1%~4% of cases. The malignant transformation occurs most frequently in the squamous epithelium with the formation of a squamous cell carcinoma. There are 10 cases reported in the literature, in Korea. We report 4 additional cases, which include 3 squamous cell carcinomas and 1 adenosquamous carcinomas, arising in cystic teratoma of the ovary.

Epidermoid Cyst of Testis in Klinefelter's Syndrome: A case report.: Seong Sook Kim, Sang Yoon Kim, Geung Hwan Ahn, Je Geun Chi; J Pathol Transl Med. 1985;19(2):220-222.

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Abstract PDF: The epidermoid cyst of the testis is a rare benign lesion with a characteristic gross and microscopic appearances. This 25 year old male who had been previously diagnosed as Klinefelter's snydrome (47/XXY) had right orchiectomy due to hard testicular nodule for a presented malignant testicular tumor. Sectioning of the testis revealed a intraparenchy matous cystic lesion, 1.5 cm in diameter, filled with cheesy white material. Histologically, stratified squamous epithelium lined the cyst. The remaining testis showed advanced tubular sclerosis and Leydig cell hyperplasia. It is necessary to submit multiple sections to rule out other histologic elements in the cyst wall or the presence of a scar. Although epidermoid cyst occurring as a solitary testicullar nodule could be regarded as a stage in the development of a teratoma, they need to be distinguished from the complex differentiated teratomas because of a distinct difference in prognosis.

Fetus-in-fetu: Report of a case.: Young Hyeh Ko, Moon Hyang Park, Doo Pyo Hong, Poong Man Jung; J Pathol Transl Med. 1985;19(2):223-225.

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Abstract PDF: A case of Fetus-in-fetu is reported. The patient was a 8 month-old-boy with a tumor in the left upper retroperitoneum. The characteristic feature of the specimen consisted of vertebral column including pelvis, both upper and lower extremities, neural canal and brain tissue, and well formed large intestine.

Sturge-Weber Syndrome: Report of an incomplete form.: Hye Yeon Kim, Kap No Lee, Seung Young Paik, Ki Chan Lee, Chang Soo Lim, Suck Ho Nam, Je G Chi; J Pathol Transl Med. 1985;19(2):226-230.

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Abstract PDF: The Sturge Weber syndrome is an uncommon disorder characterized by port-wine nevus of the face with angiomatosis of the ipsilateral cerebral leptomeninges and extensive calcification in the underlying cerebral cortex. Associated with this syndrome are mental retardation, choroidal angioma, buphthalmus or glaucoma, seizure and hemiplegia. We studied a case of incomplete form of Sturage Weber syndrome in a 12 year-old boy, who had generalized seizure, a homonymous hemianopsia, intracranial calcification and leptomeningeal angiomatosis. There are no characteristic facial nevus, mental retardation, occular changes and hemiplegia.

Spotted Grouped Pigmented Nevi: A case report.: So Young Jin, Tai Seung Kim, Kwan Chul Tark; J Pathol Transl Med. 1985;19(2):231-235.

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Abstract PDF: The spotted grouped pigmented nevi is one of special forms of non-giant congenital melanocytic nevi. Histologically the nevus cells tend to proliferate around the skin appendages. We have experienced a case of spotted ground pigmented nevi in a 11 year old girl who had a pigmented plaque consisting of grouped brown black regularly distributed papules on the left inguinal region since birth. Histology revealed intradermal nevus. The skin appendages, especially the hair follicles and eccrine sweet ducts were enveloped by the neuvs cells. Electron microscopic study revealed that this nevus cells were mostly of type B cells. We would like to consider that the spotted grouped nevi are closely related pathogenically with the skin appendages.

Lipodystrophia Centrifugalis Abdominalis Infantilis: A case report.: Chan Kum Park, Jung Dal Lee, Jae Hong Kim; J Pathol Transl Med. 1985;19(2):236-237.

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Abstract PDF: Lipodystrophia centrifugalis abdominalis infantilis, an typical form of progressive lipodystrophy, is a disease mainly decribed in japanese infants. We report a case of lipodystrophia centrifugalis abdominals infantilis in Korean infant. The patient is a 2 year-old-girl with a coin sized well defined depressed lesion with surrounding redness and scaly changes in the right inguinal region. The skin from the depressed lesion revealed changes similar to those originally described by Imamura et al.

Adenocarcinoma Arising in benign Teratoma of Mediastinum: A case report.: Seong Sook Kim, Sung Ran Hong, In Ki Paik, Ill Hyang Ko; J Pathol Transl Med. 1985;19(2):238-243.

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Abstract PDF: Although the mediastinum is the second favorite location of primary teratoma in adults, primary malignant teratoma in mediastinum is rare in incidence. Malignant teratoma includes teratocarcinoma, immature teratoma and malignant transformation in benign teratoma. The latter is rarer than others types, and undifferentiated or squamous cell carcinoma are the major incidence. We experience a case of unique adenocarcinoma composed of signet ring cells in mature teratoma of mediastinum and brief review of the literatures are included.

Clear Cell Sarcoma of Tendons and Aponeuroses: A case report with electron microscopic examination.: Woo Hee Jung, Kyu Rae Kim, In Joon Choi; J Pathol Transl Med. 1985;19(2):244-249.

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Abstract PDF: Clear cell sarcoma of tendons and aponeuroses is the term coined by Enzinger in 1965 to describe a rare but unique type of soft tisse neoplasm whose cells characteristically have the capacity to produce melanin. The authors experienced a case of 64-year old female who presented with a 6x5x4 cm sized mass deeply seated in the left popliteal fossa. The mass was firm and multinodular, and on cut section revealed patches of brown black pigmentation. Histologically the tumor was composed of round to fusiform cells with clear or pale eosinophilic cytoplasm that contained small amounts of glycogen, separated into compact nests or short fascicles by delicate septa of fibrous tissue. The brown black pigment seen in tumor cells and stroma was proven to be melanin by special stain, and ultrastructural examination showed melanosomes in varying stages of development dispersed freely in the cytoplasm or in the lysosomes. These findings strongly support the view that clear cell sarcoma is a tumor of neural crest origin rather than of tenosynovial mesenchyme origin, and is a soft tissue variant of malignant melanoma.

Metastatic Carcinoma of the Vermiform Appendix: A Report of A Case.: Ki Hwa Yang, Chang Suk Kang, Suck Jin Kang, Sun Moo Kim; J Pathol Transl Med. 1985;19(2):250-254.

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Abstract PDF: Though the primary carcinoma of the vermiform appendix is rare, the secondary carcinoma of the vermiform appendix is extremely rare. About fourty cases have been reported through the world. The breast is most common primary site, and adenocarcinoma is most common form. The metastatic carcinoma of the vermiform appendix, from squamous cell carcinoma of the uterine cervix, were extremely rare. The authors experienced a case of metastatic squamous cell carcinoma of the vermiform appendix, in thirty-two years old housewife. She was diagnosed with carcinoma of the uterine cervix on December, 1983, and treated with a radical hysterectomy on February, 1984, at Chicago, and with a radiation therapy. She had been suffered from palpable masses on left axilla and left neck region, and and coughing and chest pain. After an excision biopsy, on August, 1984, she showed intestinal obstruction sign including abdominal distension with abdominal pain. A right-sided hemicolectomy was performed on November, 1984. During gross examination, the wall of the distal portion of the vermiform appendix was moderatery thickened, and showed homogeneous light yellow cut surface. On microscopic examination, there were clusters of tumors that had negative stained preparations. On electron microscopic examination, the secretory granules were not found, and the characteristics of squamous cells, including intercellular spaces, desmosomes and tonofibrils, were noted.

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