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Volume 1(1); June 1990
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Original Articles
Fine Needle Aspiration Cytology of hepatocellular Carcinoma: A Study on 247 Cases.
Kwang Gil Lee, Jong Tae Lee, Soo Im Choi, Chan II Park
Korean J Cytopathol. 1990;1(1):1-17.
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AbstractAbstract PDF
Hepatocellular carcinoma(HCC) is malignant tumor frequently occurring in Koreans. There have been few reports regarding the cytologic findings of fine needle aspiration(FNA) of HCC. Most have suggested a diagnostic problem in the cytology distinguishing HCC from some benign hepatic lesion-for example, a regeneration nodule in cirrhosis and liver cell adenoma. In spite of its high frequency in Korea, no cytologic study has been reported, concerning the FNA of HCC. In an attempt to achieve cytologic criteria for the diagnosis of HCC, the authors studied retrospectively cytopathologic findings of 247 cases of HCC. These cases were confirmed either by histologic examination including lobectomy, biopsy, or cell block material, or, when tissue diagnosis was unavailable, by a high serum alpha-fetoprotein level(over 400 I. U.). All aspiration smears were stained by the Papainicolaou method. In each case, the smears were analyzed for cell patterns and various cytomorphology of the tumor cells. The smear background was assessed for the presence of tumor cell necrosis and inflammatory components and compared to that of metastatic carcinomas. The cell patterns were classified as trabecular, acinar, dispersed, and irregular. The cytologic parameters analyzed included the degree of nuclear atypia and the presence of mitoses, intranuclear cytoplasmic inclusions, nucleolar prominency, endothelial lining, multinucleated giant cells, eosinophilc, globules bile and Mallory body. Most of the FNA of HCC showed markedly cellular smears. The tumor cells were most frequently arranged in a trabecular pattern(80.3%). The irregular(12.6%), the acinar(5.5%), and the dispersed patterns(1.7%) followed in decreasing frequency. Individual hepatoma cells were larger than normal liver cells. However, they had morphologic features characteristic of the hepatic cells : the cells were round or polygonal, their cytoplasm was abundant and granular with eosinophilic or amphophilic stainability, and their nuclei were round to oval, located centrally, and tended to have prominent nucleoli. Anaplasia and pleomorphism of tumor cells were generally mild to moderate. These findings existed even in very well differentiated cases. Mitotic figures were present in about 85% of the cases. Prominent nucleoli were observed only in about half the cases. The frequency of other cytologic features was as follows : intranuclear cytoplasmic inclusion in 86.8% ; endothelial lining in 56.1% ; bile in 19.8% ; and giant cells in 60.1%. Clear cells were often present in 11.7%, Most aspiration smears of HCC displayed clean background without necrosis or inflammatory material in contrast to the dirty, necrotic background of metastatic cancers and cholangiocarcinomas. Based on the above mentioned features, it is suqqested that the cytologic critieria most important for the diagnosis of HCC include a markedly cellular smear, trabecular pattern. hepatocytoid appearance of tumor cells, endothelial lining, the presence of bile, giant cells, intranuclear cytoplasmic inclusions, and prominent nucleoli, Among these, trabecular pattern, endothelial lining, giant cells and clean smear background are points to be considered in differentiating HCC from metastatic and cholangiocellular carcinoma.
Experimental Studies on the Influence of Anticancer Agents upon Antibody Formation in Rabbit
Sae Ook Park
Korean J Cytopathol. 1967;1(1):3-14.
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AbstractAbstract PDF
Experimental studies were performed to observe the effects of anticancer agents on the immune response in the rabbit. Horse serum immunization and the injection of anticancer agents were continued for 3 weeks with controlled intervals. The pyroninophilic cells in the spleen, mesenteric lymphnodes and thymus were counted for the indication of antibody formation. The following results and conclusion were obtained. 1) Injections of anticancer agents show an increased number of pyroninophilic cells in the spleen and lymphnodes. The degree of this increase is highest in the mitomycin C treated group, and follows 6Mp, 5Fu, methotrexate, nitromin and nitrogen mustard treated groups in decreasing order. 2) Injections of anticancer agents with horse serum immunization show remarkable decrease of the pyroninophilic cells in the spleen and lymphnodes. This effect is most conspicuous in methotrexate and nitrogenmustacd treated group, less conspicuous in nitromin, 6MP and 5Fu treated group, and inconspicuous in mitomycin Ctreated group. 3) It may be concluded that the anticancer agents have inhibitory effects on the experimental antibody formation and the degree of this inhibitory effects is conspicuous in methotrexate, nitrogen mustard, nitromin, 6MP. 5Fu, and Mitomycin C in decreasing order. 4) The pyroninophilic cells in the thymus is neglisible in number in all experimental groups of rabbits.
A Histopathologic Study on Lung Carcinoma
Sang In Kim, Chong Soo Lee, Je G. Chi
Korean J Cytopathol. 1967;1(1):17-22.
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AbstractAbstract PDF
A Study was made on 104 cases (autopsy and biopsy) of primary lung carcinoma of Koreans obtained during a period of 10 years, 1957 to 1966, at the Department of Pathology, College of Medicine, Seoul National University. The frequency ratio or relative incidence of lung cancer among all types of malignant tumors in the same period at this Department was 4.7 per cent in male and female together, thus ranking the sixth in frequency in male and the sixteenth in female. The sex ratio of male and female was 5.5:1. The age distribution of lung cancer showed the highest frequency in the decade of 50-59 (34%) and also considerably high frequencies in the decades of 40-49 (27%) and 60-69 (26%). However, when related to the female only, 60-69 group was in the highest frequency. Ages of 104 cases ranged from 26 years to 79 years with the average of 48.2 years of age. The one hundred and four cases of lung carcinoma were classified histologically into five types : squamous cell carcinoma 45 cases (43%), adenocarcinoma 29 cases (28%), oat cell carcinoma 17 cases (16%), undifferentiated carcinoma 12 cases (12%) and mixed type 1 case (0.9%). It was emphasized that several findings of this study are in concord with the results of several other countries that are in definitely increasing tendency of lung cancer.
Cytologic Diagnosis of hepatocellular Carcinoma by Fine-Needle Aspiration Biopsy.
Ki Kwon Kim, Eun Sook Chang
Korean J Cytopathol. 1990;1(1):18-26.
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AbstractAbstract PDF
CT guided percutaneous fine-needle aspiration(FNA) of the liver for both cytologic and histologic examination has great value in diagnosing liver malignancy. From March, 1986 to April, 1990, 62 patients with the clinical impression of liver malignancy underwent CT guided percutaneous FNA biopsy. Of these, 43 cases were reviewed for this study, 19 were reported to be liver cell carcinoma, 2 were adenocarcinoma, 11 were reported as anaplastic cell present, and the rest (11 cases) were negative (9) or necrotic (2). Among the 11 cases of the last group, 9 were diagnosed as liver cell carcinoma and 2 were necrotic histologically. Retrospective review, in order to clarify the casuse of cytologic diagnostic error, of both cytologic and histologic slides of all cases showed discordance of 23% between these diagnoses and sensitivity is 93.9% and specificity is 90.9%. The reasons were as follows :1) the lack of awareness of tumor cells of well differentiated liver cell carcinoma (4 cases), 2) missed tumor cells due to too scanty cellularity (1 case), 3) improper smear (2 cases) and no tumor cell in the cytologic smears (3 cases). In such cases, at the initiation of FNA, a correct diagnosis of liver malignancy could only be made by a combination of cytologic and histologic examinations. However after three years' experience we can conclude that cytomorphologic features of liver cell carcinoma are sufficiently distinctive from other liver malignancies to be diagnostic
A Histopathologic Study on Soft Tissue Tumors
Chae Koo Lee, Sang Kook Lee, Je G. Chi
Korean J Cytopathol. 1967;1(1):25-30.
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AbstractAbstract PDF
An analysis of 336 cases of malignant and benign tumors of soft tissue, that were examined at the department of pathology, college of medicine, Seoul National University, during a period of 11 years from January 1955 to December 1965 was made. Total 336 soft tissue tumors consisted of 79 malignant and 257 benign tumors, and occupied 10 per cent of total tumors that were examined at this department during the same period. And 79 malignant soft tissue tumors occupied 3.5% of total malignancies during the same period. Seventy-nine malignant and 257 benign soft tissue tumors were histologically classified and tabulated. Among malignant tumors, fibrosarcoma, neurogenic sarcoma, fibroliposarcoma and leiomyosarcoma were especially prevalent, and among benign tumors hemangioma, lipoma, fibroma and neurofibroma were more commonly encountered. Average ages of malignant and benign soft tissue tumors were 37 and 33 years respectively. Male was slightly preponderant than female in both malignant and benign tumors. Site distributions of 336 soft tissue were also tabulated, and some tumors were selected and described in more detail.
Cytopathologic Diagnosis of Pulmonary Diseases by Transthoracic Fine Needle Aspiration Biopsy.
In Ae Park, Eui Keun Ham
Korean J Cytopathol. 1990;1(1):27-35.
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AbstractAbstract PDF
The authors report series of 360 cases of transthoracic fine-needle aspiration cytology(TFNA) from Oct, 1982, through Aug. 1986 at the Seoul National University Hospital. A diagnosis of neoplastic lesion was established in 50.3% of the cases. A non-neoplastic diagnosis was made in 38.5%, nondiagnostic one in 6.5% and inadequate one in 4.7% of the total. Statistical findings on cytological diagnoses were as follows. Specificity was 100% ; sensitivity, 92%; predictive value for positive, 1.0 ; predicitive value for negative, 0.9 : concordance rate, 84.2% ; diagnostic accuracy in non-neoplastic lesion, 65.4%, and typing accuracy in malignant tumor, 0.77.
A Case of Vesical Sarcoma Botryoides in A Child
Ki Hong Kim, Jeung Ok Park, In Hi Lee
Korean J Cytopathol. 1967;1(1):33-36.
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AbstractAbstract PDF
A 15-month-old infant who had a history of dysuria, pyuria, fever and suprapubic tumor mass for a period of days was admitted in June in 1966. The bladder was opened suprapubically. It was filled with grape-like, grey, gelatinous masses. Microscopically the surface epithelium has undergone squamous metaplastic, and neoplastic tissue reveals both myxomatous and fibromatous patterns. In the latter a few tumor giant cells with one or more nuclei are very occasionally seen. In a few areas tumor cells simulate epitheloid arrangement. No mitotic figures. No striation was found on phosphotungustic stain.
Cytologic Study of Thymoma.
Gu Kong, Se Jin Jang, Jung Dal Lee
Korean J Cytopathol. 1990;1(1):36-42.
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AbstractAbstract PDF
The fluoroscopy-guided fine needle aspiration biopsy has been gaining widespread acceptance as a rapid and effective method to make a pre-operative diagnosis of mediastinal tumors including thymoma, malignant lymphoma, and metastatic carcinoma. Although thymoma is a most common tumor of the superior mediastinum, most cytopathologists are not experted in cytologic diagnosis of this tumor because of limited experience. In order to define the diagnostic cytologic features of thymoma, we have retrospectively reviewed imprinting smears and corresponding tissue sections from four cases of this tumor. All cases revealed an apparent biphasic pattern of epithelial cell clusters and lymphocytes with occasional branching capillary fronds extending from three dimensional epithelial cell clusters. Epithelial cell clusters predominated in one case and lymphocytes in two cases. Mixed epithelial cell and lymphocyte type represented in one of four cases. In the lymphocyte predominant type, the presence of epithelial cell clusters and small mature lymphocytes are helpful features to differentiate from a malignent lymphoma.
Atheromatous Embolism -A Report of 12 Autopsied Cases-
Mun Sok Soh
Korean J Cytopathol. 1967;1(1):37-41.
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AbstractAbstract PDF
Embolic phenomenon from atheromatous material of the aorta was first found as early as 1862 by Panum. However, it was not until 1945 that Flory described in detail the pathologic processes of atheromatous embolization in bath human and experimental animals and stressed the importance of its sequelae. Since that time, the cases have been recognized with increasing interest and frequency. Recently, Gore and Collins collected 84 cases and added 16 cases of their own. It Is a purpose of this paper to report 12 additional cases experienced at Georgetown University Hospital, Washington, D.C., U.S.A., and to reemphasize the clinicopathological correlations leading to the following conclusions. Summary and Conclusions 1. Clinicopathological observations on 12 autopsied cases of atheromatous embolism were presented with review of the literatures. 2. Significant clinical implications of the embolism was discussed with particular emphasis on the necessity to differentiate it from true arteritis. 3. All the cases revealed severe ulcerative atherosclerosis of the aorta in common and had as sociated aneurysms in the 8 cases. 4. Many varieties of organs and tissues could be involved and especially the kidney, pancreas and spleen were the three major organs most frequently affected. 5. In none of the cases the atheromatous embolism were immediate cause of death. However, in 4 cases at least it was definitely contributory factor to death.
Fine Needle Aspiration Cytology of the Mediastinal Lesions.
In Ae Park, Eui Keun Ham
Korean J Cytopathol. 1990;1(1):43-50.
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AbstractAbstract PDF
The authors report 16 cases of mediastinal fine-needle aspiration cytology from Jan. 1985 to Mar. 1988 at the Seoul National University Hospital. Among them, diagnostic materal were obtained in fifteen cases, establishing the diagnosis of 7 thymomas, 2 germinomas, 2 neurogenic tumosr, 1 lymphoma, and 3 meastatic carcinomas. The 9 cytologic diagnoses could be confirmed by histologic examination in 8 patients and by another cytologic method in one patient, allowing concordance rate of 77%.
Pulmonary Hypoplasia Associated with Congenital Diaphragmatic Hernia
Kyu Sun Rhee, Je G. Chi
Korean J Cytopathol. 1967;1(1):43-47.
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AbstractAbstract PDF
Two autopsy cases of pulmonary hypoplasia associated with congenital diaphragmatic hernia(Bochdalek foramen) have been presented. The first case is a 12-hour-old new born infant, who was admitted for cyanosis and dyspnea. At operation, the left hemithorax was filled with loops of small intestine which had been herniated through a large defect in the left posterolateral portion of the diaphragm. The defect was properly repaired. However, the patient expired soon after operation showing persistent respiratory difficulty. At autopsy, both lungs were hypoplastic especially in the left, and no evidence of expansion was noted under the microscope. The second case is a 3-day-old newborn infant who was admitted for cyanosis and general weakness. Soon after admission the patient expired. At autopsy, left lung weighed only 5 gm. and consisted of a rather stolid dark gray mass attached to the hilum. The spleen and loops of small intestine were found in the left hemithorax which had been herniated through a round defect in the left posterolateral portion of diaphragm. Pathogenesis of pulmonary hypoplasia associated with diaphragmatic hernia of congenital origin is discussed and the related papers are briefly reviewed.
Fine Needle Aspiration Biopsy Cytology of Breast Tumors.
In Sook Kim, Jung Dal Lee
Korean J Cytopathol. 1990;1(1):51-59.
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AbstractAbstract PDF
Fine needle aspiration biopsy cytology (FNA) for diagnosis of a variety of breast tumors has been proven to be a simple, sate, and cost saving diagnostic methodology with high accuracy. Cytologic specimens from 1,029 fine needle aspirations of the breast during last 3-year period were reviewed and subsequent biopsies from 107 breast lesions were reevaluated for cytohistological correlation. FNA had a sensitivity of 81.6% and a specificity of 98.3%. One out of 107 cases biopsied revealed a false positive result (0.9%) and the case was due to misinterpretation of apocrine metaplastic cells in necrotic background as malignant cells. A false negative rate was 8.4% (9 of 107 cases biopsied). Six of 9 false negative cases were resulted from insufficient aspirates for diagnosis, and remaining three of 9 false negative cases revealed extensive necrosis with no or scanty viable cells on smears. The results indicate that for reducing false positive and false negative rates of FNA, an experienced cytopathologist and a proficient aspirator are of great importance.
Diagnostic Features of Fine Needle Aspiration Cytology of Pleomorphic Adenoma, Adenoid Cystic Carcinoma, and Mucoepidermoid Carcinoma of Salivary Gland.
Eun Sook Nam, Won Bo Jo, Jung Ho Han, Insun Kim
Korean J Cytopathol. 1990;1(1):60-67.
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AbstractAbstract PDF
The evaluate the diagnostic findings of salivary gland tumors, we reexamined aspiration cytology smears of 7 cases of pleomorphic adenoma, 3 cases of adenoid cystic carcinoma, and 3 cases of mucoepidermoid carcinoma, performed during April 1986 to March 1990, which were comfurmed by surgical excision and histologic diagnosis. The results obtained are summarized as follows : 1. All cases of pleomorphic adenoma showed branching cellular clusters of epithelial and myoepithelial cells. Acellular elements including myxomatous and chondroid components were observed. There were no cellular pleomorphism and nucleoli. Keratinizing squamous epithelial cells and keratin pearls were noted. 2. The smears of adenoid cystic carcinoma showed cell balls or cell cords containing a central hyaline core. Nuclear atypism and the nucleoli were frequently observed. There were no keratinizing squamous epithelial cells. 3. The smears of mucoepidermoid carcinoma showed mainly sheets or clusters of intermediate cells and some mucin-producing cells. Some nuclear pleomorphism was observed. Mucinous material and many inflammatory cells were present in the background.
Fine Needle Aspiration Cytology in the Diagnosis of Tuberculosis.
Dong Wha Lee, So Young Jin, Eun Suk Koh, Chung Ja Kwak
Korean J Cytopathol. 1990;1(1):68-73.
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AbstractAbstract PDF
A total 48 cases of tuberculous lesion in the lymph nodes(43 cases), lung (3 cases) and soft tissue(2 cases), was subjected to fine needle aspiration cytology(FNAC). The age of the patients ranged from 19 to 77 year-old(average 33.6 years in age) and the male to female ratio was 1:4. Thirty-four cases (70.8%) demonstrated distinct granulomatous reaction with or without caseastion necrosis, nine cases(18.8%) showed no granulomas, but large amount of necrotic debris with numerous polymorphonuclear cells and histiocytes, and five cases (10.4%) revealed acellular material only. The overall AFB positivity in smears was 62.5%. In areas associated with granulomatous reaction and necrosis, AFB positivity was 55.8%, while it was 80.0% in cases with acellular necrotic material. There were 2 cases of parasitic infestation which could not be easily differentiated from tuberculosis based on aspiration smears only.
Application of Immunohistochemical Technique in the Cytologic Diagnosis of herpes Simplex Virus Infection.
Hye Rim Park, Kap No Lee, Seung Young Paik
Korean J Cytopathol. 1990;1(1):74-84.
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AbstractAbstract PDF
Herpes simplex virus type 1 and 2(HSV-1, HSV-2) are the ubiquitous human pathogens responsible for a variety of afflictions, HSV-2 is one of the viruses that were suspected of promoting carcinogenesis in the uterine cervix. Certainly, there is a need for the more sensitive and accurate laboratory techniques for HSV detection. We examined total 80 cases of smears including 17 Tzanck smears of skin and 63 cases of Papanicolaou smears from total 77 patients with clinical impression of herpetic infections, from September, 1985 through August, 1989. Immunohistochemical typings for HSV-1 and HSV-2 were performed together with routine cytologic findings and compared The results are as follows : 1) patients were 9 males and 33 females, and age distribution was between 5 and 71 years 2) Subjective symptoms such as ulceration, vesicle, vaginal discharge, pruritus, and pain were complained in 36 patients and 38 cases were genital herpes. Recurrence was noted in 11 cases. 3) Positive results were obtained in 42 among 80 cases. 4) Both routine cytology and imunohistochemical staining were positive in 13 cases and in 24 cases only immunohistochemical staining were positive. 5 cases were positive only in routine cytologic smears. 5) The cases that immunocytochemical stain had been performed were 37 cases, which were all positive in type 2, Among the above 37 cases, type 1 also were positive in 5 cases. The results show that the immunoperoxidase technique is one of the rapid and reliable method to confirm the herpetic infection when suspected and that it is particularly useful when the Papanicolaou smear findings are equivocal

JPTM : Journal of Pathology and Translational Medicine