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Volume 17(1); March 2006
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Original Article
Cytopathology of Urinary Tract Neoplasms.
Eun Kyung Hong
Korean J Cytopathol. 2006;17(1):1-17.
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  • 11 Download
AbstractAbstract PDF
Urine cytology is the most useful technique for detecting either primary or recurrent neoplasms in the urinary tract. Although urine cytology is the traditional method of detecting these neoplasms, its diagnostic accuracy has been underevaluated because of low sensitivity. The cytologic interpretation of urinary samples is not an easy task, even with some expertise in this area, for many reasons. In low-grade urothelial carcinoma, no reliable or reproducible diagnostic cytologic criteria can be provided because of the lack of obvious cytologic features of malignancy, which is one of the main factors lowering its diagnostic accuracy. Many diagnostic markers have been developed recently to enhance its diagnostic yield, but the results have not been satisfactory. However, urine cytology plays a role in detecting high-grade urothelial carcinoma or its precursor lesions. It still shows higher specificity than any of the newly developed urine markers. Understanding the nature of urine samples and the nature of neoplasms of the urinary tract, recognizing their cytologic features fully, and using cytologic findings under appropriate conditions in conjunction with a detailed clinical history would make urine cytology a very valuable diagnostic tool.
Etcs
Morphologic Studies on the Endometrium of Abnormal Uterine Bleeding with Special Emphasis on Dysfunctional Uterine Bleeding
Young Hyeh Koh, Chan Il Park, In Joon Choi, Yoo Bock Lee
Korean J Cytopathol. 1983;17(1):1-9.
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AbstractAbstract
Abnormal uterine bleeding is one of the most common symptoms in gynecologic disorders of which dysfunctional uterine bleeding (DUB) is frequently encountered. Although the correct diagnosis of DUB relies on various assessments such as the menstrual cycle, basal body temperature, endocrine assay, vaginal cytology and endometrial histologic findings, pathologists have been encountered in many instances which have to make a diagnosis on the endometrium only. In view of great difficulties to make a proper histologic evaluation of endometrium in cases of DUB, the present study is undertaken to asses the pattern of the endometrium in DUB among Koreans. The material consisted of 123 cases of endometrial curettage specimens diagnosed as DUB, among which 17 cases were subjected to total hysterectomy. Histologic examination was carried out through routine formaline fixed-paraffin embedding methods followed by hematoxylin-eosin staining routinely and other special stainings as required. Histologic pattern of the endometrium was classified according to Handrickson and Kempson (1980) and clinical correlation was made. The following results were obtained: 1) The pattern of the endometrium in DUB was predominantly non-secretory type (77 cases) and the secretory type was observed in 46 cases. Abnormal endometrial histology was found in 73 cases of which 59 cases was non-secretory and 14 cases secretory type. 2) The incidence of anovulatory bleeding in DUB was 59%. 3) The bleeding pattern was mostly metrorrhagia but menometrorrhagia was predominant in cases of hyperplasia. 4) The incidence of recurrent bleeding was 31% and relatively higher in secretory endometrium.
A Histopathologic Study on Malignant Lymphoma among Koreans
Sung Sik Shin, Geung Hwan Ahn, Sang Kook Lee
Korean J Cytopathol. 1983;17(1):10-20.
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AbstractAbstract
A total of 160 cases of non-Hodgkin's lymphoma were obtained form the file of Department of Pathology, Seoul National University Hospital during a period of 5 years beginning from 1976 to 1980. These tumors were classified according to modified Rappaport and Lukes-Collins classifications. The patient ranged in age from 1 to 84 years, with an average of 36.9 years. One hundred and ten patients were male and 50 were female, and male-to-female ratio was 2.2 : 1. Of 160 cases, 5 cases (3.0%) were nodular lymphoma and 155(96.9%) were diffuse lymphoma. Nodular lymphomas consisted of 4 cases (2.5%) of histiocytic type and 1 case(0.6%) of mixed type. Diffuse lymphomas consisted of 93 cases (58.1%) of histiocytic type, 32 cases (20.0%) of poorly differentiated lymphocytic type, 16 cases (10.0%) of lymphoblastic type, 8 cases (5.0%) of mixed type, 3 cases (1.9%) of undifferentiatiated Burkitt type, 2 cases (1.3%) of undifferentiated pleomorphic type, and 1 case (0.6%) of mycosis fungoides. Cases of nodular poorly differentiated lymphocytic and diffuse well differentiated lymphocytic type were not found. Fourteen of 16 lymphoblastic lymphomas occurred under the age of 20. Nodular type was not present under the age of 20. Analysis of biopsy sites disclosed 69 cases (43.1%) from lymph node and 91 cases (56.9%) of extranoal sites. Most frequent extrandodal site was tonsil, followed by gastrointestinal tract, subcutaneous tissue, oral cavity, nasal cavity and nasopharynx. In summary, the low frequency of nodular lymphoma and extreme rarity (none in this series) of well differentiated lymphocytic lymphoma were confirmed and the most frequent type was diffuse histiocytic lymphoma. Detailed discussion of morphologic characteristics and comparison of Rappaport and Lukes-Colline classifications were done.
Original Article
New Techniques for the Detection of the Malignant Cells in Urine Cytology.
Gyungyub Gong
Korean J Cytopathol. 2006;17(1):18-26.
  • 1,666 View
  • 34 Download
AbstractAbstract PDF
Transitional cell carcinoma of the urinary bladder is common in the genitourinary tract. The gold standard for the diagnosis of bladder cancer has been cystoscopy, along with urine cytology. Cystoscopy is an invasive and relatively expensive technique. By comparison, urine cytology is easy to perform and specific for a diagnosis of bladder cancer, although less sensitive, especially in low-grade tumors. For this reason, there has been a need for superior noninvasive technology to increase our confidence in being able to detect bladder cancer. There are many reports of the various urinary tests that are available to facilitate the diagnosis. In this article, I reviewed the literature on urinary markers and tests that may be clinically useful, including fluorescence in situ hybridization, uCyt+/Immunocyte, the BTA(R) test, the NMP 22TM, the FDP(R) test, the telomerase activity test, the HA and HAse tests, and flow cytometry. Most of these tests have a higher sensitivity and specificity than cytology. However, urine cytology has the highest specificity, especially in individuals with a high-grade tumor. We conclude that no urinary markers or tests can replace the role of cystoscopy along with cytology in the diagnosis of transitional cell carcinoma of the bladder. However, some markers could be used adjunctively to increase the diagnostic accuracy during screening or during the postoperative follow-up examination of patients with bladder cancer.
Etcs
Influence of Specimen Evaporation to Chemical Analytical Values
J.H. Um, H.R. Park, K.E. Cheong, M.J. Cho
Korean J Cytopathol. 1983;17(1):21-25.
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AbstractAbstract
Serum sample, selected and control sera stored in various environment indicated, ie., refrigerating or room temperature, were analyzed to evaluate the effects of evaporation due to storing condition on sample weight and analytical values. The storage period choiced are 4 hours and the results analyzed are ase as follow: 1) The serum sample stored in room air revealed 13.39% decrease in weight and 7.1% decrease in refrigerator. 2) The analytical value of the serum sample and control sera stored in room air revealed obvious increase ie., 24.4~24.2% in SGOT., 16.6~29.4% in SGPT., 25.8~8.2% in Alk. phosphatase, 9.7~11.7% in total protein, 13.1~19.4% in albumin and 15.6~3.2% in cholesterol. The more striking alterations are noted in enzyme items of serum than in nen-enzyme than in non-enzyme items. 3) The serum and control sera sample stored in refrigerator revealed increased value of 9.8~10.3% in SGOT., 6.3~5.3% in SGPT., 1.1~2.5% in Alk. prosphatase, 2.7~1.5% in total protein, 5.2~4.5% in albumin and 3.0~5.0% in cholesterol. 4) It is, therefore, recommended that should be stored the serum samples in the refrigerator until tested which obviously alleviate the evaporative loss of weight and analytical variations.
A Comparative Study on the Value of Rheumatoid Factor Determined with Nephelometric and Latex Agglutination Methods
In Suck Song
Korean J Cytopathol. 1983;17(1):26-31.
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AbstractAbstract
The present study was done to compare the laser nephelometry with the latex agglutination test for the determination of rheumatoid factor. The following results were obtained. 1) The latex agglutination method was simple for qualitative tests but the nephelometry method was simpler and more accurate than the other for quantitative tests. 2) With the nephelometric method, endpoints were objectively assessed and standardization was easy. 3) In quantitative tests, the data were highly reproducible with the nephelometry method. 4) Both methods were generally similar in specificity and sensitivity but the nephelometry was more specific than the other in progressive and convalescent stages of the disease.
Original Articles
Fine Needle Aspiration Cytology of Periductal Mastitis (Subareolar Abscess) and its Clinical Significance of Cytological Diagnosis.
Han Seong Kim, Mee Joo, Sun Hee Chang, Ji Eun Kwak, Sung Hye Park, Byung Ju Song
Korean J Cytopathol. 2006;17(1):27-31.
  • 3,001 View
  • 71 Download
AbstractAbstract PDF
Periductal mastitis is a specific clinicopathologic entity, and is referred to by several names: recurrent subareolar abscess, squamous metaplasia of the lactiferous duct, and Zuska's disease. Clinically, the differentiation of periductal mastitis from other benign lesions and carcinomas around the nipple frequently proves a difficult proposition. We reviewed the fine needle aspiration cytology (FNAC) of 14 cases of periductal mastitis, which had been diagnosed either radiologically, histologically, or clinically. The patient group included 13 female patients, and one male. The majority of the patients in this group had presented with subareolar masses. All cases evidenced characteristic anucleated squamous cell clusters within a mixed inflammatory background. A diagnosis of periductal mastitis can be rendered fairly readily on excisional biopsy. However, FNAC is considered to be superior to excisional biopsy as an initial diagnostic procedure for any palpable mass in subareolar lesions of the breast. FNAC can also be a useful diagnostic technique in cases of periductal mastitis, even in the early phases of the disease. A definitive diagnosis of subareolar abscess via FNAC will enable the clinician to select the most appropriate medical or surgical treatment.
Cytologic Findings of Clear Cell Carcinoma of Ovary.
Ji Young Park, Hye Sun Kim, Jong Sun Choi
Korean J Cytopathol. 2006;17(1):32-37.
  • 1,869 View
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AbstractAbstract PDF
The objective of this study was to evaluate the cytomorphologic features of histologically confirmed clear cell carcinoma of the ovary and to evaluate the applicability of scrape or fine-needle aspiration cytology in making an intraoperative diagnosis. We reviewed scrape or fine-needle aspiration cytology findings in tissues taken from 6 patients with clear cell carcinoma of the ovary. The cytologic diagnosis was based primarily on findings in alcohol-fixed, hematoxylin-eosin (H-E) stained smears. The formation of material resembling a basement membrane was a characteristic finding in these smears. This extracellular hyaline material was stained light pink with H-E and was frequently found within tumor cell clusters as well as in the background material. Multinucleated giant cells were found occasionally. Each tumor cell had an abundant, clear, or granular cytoplasm with a distinct cellular membrane. Scrape cytology is a simple and rapid supportive method and could be helpful in diagnosing clear cell carcinoma of the ovary, especially when marked artifacts appear in the frozen section.
Etc
Prevalence of Methicillin-resistant Staphylococcus and the Antimicrobial Susceptibility
Kyng Sook Kim, Yunsop Chong, Oh Hun Kwon, Samuel Y. Lee
Korean J Cytopathol. 1983;17(1):32-37.
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AbstractAbstract
Although increasing incidence of infections with methicillin-resistant Staphylococcus aureus (MRSA) has been reported in other countries, the situation of our country is not clearly ascertained. S. aureus isolated from various clinical specimens at Yonsei Medical Center was tested for the antimicrobial susceptibility by the Kirby-Bauer method. The MRSA isolated in 1981 was tested for the antimicrobial susceptibility by agar dilution method. Following results were obtained. 1) Increased prevalence of MRSA from 0% to 31.7% was noted during the period of August 1979 to June 1982. 2) MRSA was isolated only from inpatients but not from outpatients. No difference was noted in the isolation rate by sources of specimen. 3) Cephalothin was the most active drug against MRSA, showing the lowest MIC range, MIC50 and MIC90. Among the MRSA isolates, 91.2% was susceptible to this drug. 4) To amikacin, 58.8% of the MRSA was susceptible while all were resistant to dibekacin, gentamicin, tobramycin. It is concluded from this study that infections due to MRSA is increasing among inpatients, and increasing difficulty is anticipated to control MRSA infection as the amikacin is the only active aminoglycoside.
Original Article
Utility of Bile Duct Brush Cytology in Pancreaticobiliary Diseases: Prospective Comparative Study of Conventional Smear and MonoPrep2(TM) Liquid Based Cytology.
So Young Jin, Dong Wha Lee, Mee Sun Kim, Young Deok Cho, Young Koog Cheon, Min Sung Choi, Dong Won Kim
Korean J Cytopathol. 2006;17(1):38-45.
  • 1,462 View
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AbstractAbstract PDF
Bile duct brush cytology has been employed as a diagnostic tool for the evaluation of pancreatic and biliary tract strictures. The specificity of this method is high however, its sensitivity is quite low. A recent study employing liquid based cytology (LBC) reported results comparable to those achieved via conventional cytology. Therefore, we have attempted to prospectively evaluate the diagnostic utility of bile duct brush cytology in pancreaticobiliary diseases. A total of 46 cases with bile duct stricture were enrolled including 11 cases of benign stricture, 29 cases of bile duct carcinoma, 3 cases of gallbladder cancer, and 3 cases of pancreatic cancer. Both conventional smear and LBC using MonoPrep2(TM) system were conducted in each case. The cytological diagnosis of each case was classed into the following categories; benign, suspicious for malignancy, and malignancy. The diagnostic accuracy of both cytologic methods was investigated. LBC evidenced a high rate of material insufficiency (13/46), which was attributed to low cellularity. The kappa index of both cytological methods was 0.508. Cytological and tissue diagnoses were correlated in 25 cases conducted from biopsy or operation. The sensitivity, specificity, positive predictive value, and negative predictive value were 41.2% (7/17), 100% (8/8), 100% (7/7), and 44.4% (10/18) in conventional smear; 58.8% (10/17), 87.5% (7/8), 90.9% (10/11), and 50.0% (7/14) in LBC; and 94.1% (16/17), 87.5% (7/8), 94.1% (16/17), and 87.5% (7/8) in any one of both cytological methods, respectively. Based on these results, the sensitivity of LBC was found to be superior to that of conventional smear and we were able to obtain higher positive predictive value upto 94.1% by simultaneously conducting both cytologic methods.
Etc
Anaerobic Culture Results of Clinical Specimens and Antimicrobial Susceptibility of Bacteroides Isolates
Hee Joo Lee, Yunsop Chong, Samuel Y. Lee
Korean J Cytopathol. 1983;17(1):38-45.
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AbstractAbstract
In order to determine the recent trend of anaerobic bacteria isolation and the susceptibility of Bacteroides to antimicrobial agents, an analysis was made on the data of routine anaerobic cultures at Yonsei Medical Center during the period of September 1980 to August 1981. The following results were obtained. 1) A total of 336 isolates of anaerobic bacteria were obtained from various clinical specimens. Among the isolates 38.7% were gram-positive cocci and 53.3% were gram-negative bacilli. 2) Peptococcus magnus(20.3%) and P. asaccharolyticu(16.5%) were the frequently isolated gram-positive cocci and B. fragilis(70.4%) and B. thetaiotaomicron(15.1%) were the frequently isolated gram-negative bacilli. 3) Anaerobic bacteria were frequently isolated from specimens of abdomen and female genital tract. Peritonitis and intra-abdominal abscess were frequent clinical findings. 4) Among the anaerobe positive specimens, 22.4% yielded anaerobes alone while the remaining 77.6% also yielded aerobic bacteria. 5) Most of the B. fragilis and B. thetaiotaomicron isolates were susceptible to cefoxitin and chloramphenicol, but resistant to tetracycline.
Case Report
Micropapillary Variant of Urothelial Carcinoma of the Urinary Bladder: Report of a Case with Cytologic Diagnosis in Urine Specimen.
Young Seok Lee, Hyunjoo Lee, Jung Woo Choi, Bongkyung Shin, Hankyem Kim, Insun Kim, Aeree Kim
Korean J Cytopathol. 2006;17(1):46-50.
  • 1,365 View
  • 13 Download
AbstractAbstract PDF
A micropapillary variant of urothelial carcinoma (MPC) is a distinct entity with an aggressive clinical course. It has a micropapillary configuration resembling that of ovarian papillary serous carcinoma. Its cytologic features have rarely been reported. We report a case of MPC detected by urine cytology. A woman aged 93 years presented with a chief complaint of macroscopic hematuria. Cytology of her voided urine showed clusters of malignant cells in a micropapillary configuration. Each tumor cell had a vacuolated cytoplasm, a high nuclear:cytoplasmic ratio, and irregular hyperchromatic nuclei. An ureteroscopic examination revealed exophytic sessile papillary masses extending from the left lateral wall to the anterolateral wall of the urinary bladder. A transurethral resection of the tumor was carried out. The tumor was characterized by delicate papillae with a thin, well-developed fibrovascular stromal core and numerous secondary micropapillae lined with small cuboidal cells containing uniform low- to intermediate-grade nuclei and occasional intracytoplasmic mucinous inclusions. These tumor cells infiltrated the muscle layers of the bladder, and lymphatic tumor emboli were frequently seen. Recognizing that the presence of MPC components in urinary cytology is important for distinguishing this lesion from low-grade papillary lesions and high-grade urothelial carcinomas can result in early detection and earlier treatment for an improved treatment outcome.
Etc
Scanning Electron Microscopy of the Ultrastructure of Pancreatic Acinar Cells
Kun Young Kwon, Jyong Sik Kwak, Tae Joong Sohn
Korean J Cytopathol. 1983;17(1):46-52.
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AbstractAbstract
Several methods of tissue preparation and different modes of operation of the scanning electron microscope were used to study the ultrastructure of cells. The author examined ultrastructure of rat pancreatic acinar cells prepared by Osmium-DMSO-Osmium and subsequent cracked with razor blade, and discussed the scanning electron microscope images in comparison with light microscopic and transmission electron microscopic findings. The results were as follow. The ultrastructure of pancreatic acinar cells prepared by Osmium-DMSO-Osmium method was well exposed. The transmission electron microscopy easily revealed the cellular organelles which were poorly visualized by light microscope. The ultrastructures of pancreatic acinar cells studied by SEM were well correlated with results obtained by TEM. The surface of nuclear membrane was smooth. Mitochondria were round or elongated and had many cristae. RER arranged in lamellar pattern with occasional dilatation. Golgi complex was composed of vesicles, lamellae and vacuoles. The inner surfaces of above mentioned organelles revealed relatively granular textures. One important point revealed by cracked samples concerns the findings of spherical secretory granules within thin walled cavities, which suggestive of Golgi vesicle origin. These vesicles appear connected by small openings. It is suggested that they may represent a system of intercommunicating chambers(vacuoles).
Case Report
Cytologic Findings of a Plasmacytoid Variant of Urothelial Carcinoma of the Urinary Bladder in Voided Urine.
Soo Jin Jung, Joo Yeon Song, Hye Kyoung Yoon, Sung Hyup Choi
Korean J Cytopathol. 2006;17(1):51-55.
  • 1,564 View
  • 23 Download
AbstractAbstract PDF
The plasmacytoid variant is an extremely rare form of urothelial carcinoma in which the malignant cells resemble those of plasmacytoma. We report the cytologic features of 3 cases of this disorder. All 3 patients were male and presented with painless macroscopic hematuria. The voided urine cytology revealed a few scattered clusters of tumor cells in a bloody background. Each tumor cell had an abundant amount of cytoplasm that was clear or densely stained and characterized by eccentrically located nuclei. A histological examination of tissue obtained from a radical cystectomy confirmed the cytologic diagnosis in each 3 case, revealing a diffusely infiltrating tumor composed of round, noncohesive tumor cells demonstrating a high nuclear grade. These cells had infiltrated the tunica propria in 2 cases, but were limited to the submucosa in 1 case. The tumor cells were plasmacytoid in appearance, each demonstrating an eccentric nucleus and dense cytoplasm, as seen in the cytologic findings. All of the tumors were immunoreactive for pancytokeratin, CK7, CK20; negative for epithelial membrane antigen (EMA), leukocyte common antigen (LCA), kappa, lambda, and CD79a. Thus, it is important to consider the plasmacytoid variant of urothelial carcinoma in addition to plasmacytoma or lymphoma as a diagnosis when encountering plasmacytoid tumor cells in a voided urine sample.
Etc
Adenocarcinoma arising in Intrapulmonary Teratoma
Eun Kyung Hong, Jung Dal Lee, Seh Young Yuh*, Jae Kwon Chin*, Yup Yoon**
Korean J Cytopathol. 1983;17(1):53-59.
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AbstractAbstract
A rare case of malignant intrapulmonary teratoma is reported. The patient, 50 year old female, had suffered from symptoms characteristic of a benign intrapulmonary teratoma more than twenty years. After the confirmation on a bronchoscopic biopsy of adenocarcinoma arising in the pre-existing benign teratoma, left pneumonectomy was performed. The adenocarcinomatous component metastasized to the contralateral lung one year after the pneumonectomy, and the patient died in 3 months after the metastasis. The histogenesis, clinical behavior and pathologic features of intrapulmonary malignant teratoma are discussed, and the rarity of the pulmonary location of this lesion is emphasized.

JPTM : Journal of Pathology and Translational Medicine