Skip Navigation
Skip to contents

JPTM : Journal of Pathology and Translational Medicine

OPEN ACCESS
SEARCH
Search

Previous issues

Page Path
HOME > Articles and issues > Previous issues
40 Previous issues
Filter
Filter
Article category
Keywords
Authors
Volume 19(2); September 2008
Prev issue Next issue
Reviews
Quality Control Program and Its Results of Korean Society for Cytopathologists.
Hye Kyung Lee, Sung Nam Kim, Shin Kwang Khang, Chang Suk Kang, Hye Kyoung Yoon
Korean J Cytopathol. 2008;19(2):65-71.
DOI: https://doi.org/10.3338/kjc.2008.19.2.65
  • 1,942 View
  • 18 Download
AbstractAbstract PDF
In Korea, the quality control(QC) program forcytopathology was introduced in 1995. The program consists of a checklist for the cytolopathology departments, analysis data on all the participating institutions' QC data, including the annual data on cytologic examinations, the distribution of the gynecological cytologic diagnoses, as based on The Bethesda System 2001, and the data on cytologic-histolgical correlation of the gynecological field, and an evaluation for diagnostic accuracy. The diagnostic accuracy program has been performed 3 times per year with using gynecological, body fluid and fine needle aspiration cytologic slides. We report here on the institutional QC data and the evaluation for diagnostic accuracy since 2004, and also on the new strategy for quality control and assurance in the cytologic field. The diagnostic accuracy results of both the participating institutions and the QC committee were as follows; Category 0 and A: about 94%, Category B: 4~5%, Category C: less than 2%. As a whole, the cytologic daignostic accuracy is relatively satisfactory. In 2008, on site evaluation for pathology and cytology laboratories, as based on the "Quality Assurance Program for Pathology Services" is now going on, and a new method using virtual slides or image files for determining the diagnostic accuracy will be performed in November 2008.
The Cytopathology of Body Cavity Fluid.
Eun Kyung Hong
Korean J Cytopathol. 2008;19(2):72-85.
DOI: https://doi.org/10.3338/kjc.2008.19.2.72
  • 1,751 View
  • 18 Download
AbstractAbstract PDF
Cytologic examination of the body cavity fluid is very important because the specimens represent a significant percentage of nongynecologic samples and this cytologic examination may be the first, best or only chance for making the diagnosis of an underlying malignancy. The purposes of body cavity fluid examination are to correctly identify cancer cells and if possible, to identify the tumor types and primary sites when presented with unknown primary tumor sites. The most important basic differential diagnosis is that of benign and reactive disease vs malignant disease. Reactive mesothelial cells are a consistent population in body cavity fluid, and these are the most versatile cells in the body. Due to the specific environment of the body cavity, the exfoliated reactive mesothelial cells may show significant morphologic overlap with the morphology of cancer cells. With a focus on the differential points between reactive mesothelial cells and metastatic adenocarcinoma cells, the practical diagnostic approaches, the diagnostic clues and the pitfalls to achieve a correct diagnosis are presented in this review.
Cytologic Findings of Cerebrospinal Fluid.
So Young Jin
Korean J Cytopathol. 2008;19(2):86-98.
DOI: https://doi.org/10.3338/kjc.2008.19.2.86
  • 1,654 View
  • 15 Download
AbstractAbstract PDF
Cerebrospinal fluid (CSF) cytology is based on the cytopathologic findings of other body fluids. However, CSF's cytologic features are less familiar to physicians than are those of the other body fluid's cytology because of the small number of cases. The low overall diagnostic accuracy and the presence of false positivity still remain as problems. The incidence of lymphoreticular malignancies and metastatic carcinomas are rather higher than that of primary brain tumors. In this review, the characteristic cytologic findings of conventional CSF cytology are reviewed along with a brief note on the technical preparation and diagnostic pitfalls.
Original Articles
Second Opinion Diagnoses of Cytologic Specimens on Consultation : Asan Medical Center Experience.
Sohyung Park, Jae Y Ro, Kyung Ja Cho, Gyungyub Gong, Yong Mee Cho, Shin Kwang Khang
Korean J Cytopathol. 2008;19(2):99-106.
DOI: https://doi.org/10.3338/kjc.2008.19.2.99
  • 1,607 View
  • 11 Download
AbstractAbstract PDF
BACKGROUND
Second opinion diagnosis of outside pathology slides is a common practice for efficient and proper patient management. We analyzed cytology slides from outside hospitals submitted for a second opinion diagnosis to determine whether the second opinion diagnosis had any influence on patient care.
METHODS
We reviewed 1,153 outside cytology slides referred to Asan Medical Center for second opinions from January, 2007, to December, 2007. All cases were categorized into three groups; no diagnostic discrepancy, minor diagnostic discrepancies (no impact on the management), and major diagnostic discrepancies (significant impact on the management and subsequent follow-up).
RESULTS
The thyroid was the most common organ system (933 cases, 80.9%). Forty cases (3.6%) belonged to the major diagnostic discrepancy group and 149 cases (12.8%) to the minor discrepancy group. For validation of second opinion diagnoses in major discrepancy cases, subsequent biopsy or surgical resection specimens and clinical information were reviewed, which were available in 29 cases. The second opinion diagnoses resulted in alteration of clinical management in 21 of 29 cases.
CONCLUSION
For all referred patients, second opinion diagnosis is important and mandatory for appropriate patient care.
The Usefulness of Cervicovaginal Cytology as a Primary Screening Test.
Jae Hong Park, Seung Yeon Ha, Hyun Yee Cho, Dong Hae Chung, Na Rae Kim, Sanghui Park
Korean J Cytopathol. 2008;19(2):107-110.
DOI: https://doi.org/10.3338/kjc.2008.19.2.107
  • 1,598 View
  • 11 Download
AbstractAbstract PDF
We evaluated the usefulness of cervicovaginal cytology as a primary screening test by analyzing the cytologic and histological diagnoses of 2,254 women. Cervicovaginal cytology had 93.0% sensitivity, 86.1% specificity, 88.2% positive predictive value, and 91.7% of negative predictive value. Cervicovaginal cytology as a primary screening test showed much higher specificity but slightly lower sensitivity than HPV DNA testing. However, the sensitivity of cervicovaginal cytology will be improved continuously due to the development of liquid-based cytology. We regard cervicovaginal cytology as a good primary screening test for cervical intraepithelial neoplasia or carcinoma.
Diagnostic Accuracy of Cervicovaginal Cytology in the Detection of Squamous Epithelial Lesions of the Uterine Cervix; Cytologic/Histologic Correlation of 481 Cases.
So Young Jin, Sang Mo Park, Mee Sun Kim, Yoon Mi Jeen, Dong Won Kim, Dong Wha Lee
Korean J Cytopathol. 2008;19(2):111-118.
DOI: https://doi.org/10.3338/kjc.2008.19.2.111
  • 1,721 View
  • 12 Download
AbstractAbstract PDF
BACKGROUND
Cervicovaginal cytology is a screening test of uterine cervical cancer. The sensitivity of cervicovaginal cytology is less than 50%, but studies of cytologic/histologic correlation are limited. We analyzed the diagnostic accuracy of cervicovaginal cytology in the detection of the squamous epithelial lesions of the uterine cervix and investigate the cause of diagnostic discordance. MATERIALS AND METHODS: We collected a total of 481 sets of cervicovaginal cytology and biopsies over 5 years. The cytologic diagnoses were categorized based on The Bethesda System and the histologic diagnoses were classified as negative, flat condyloma, cervical intraepithelial neoplasia (CIN) I, CIN II, CIN III, or squamous cell carcinoma. Cytohistologic discrepancies were reviewed.
RESULTS
The concordance rate between the cytological and the histological diagnosis was 79.0%. The sensitivity and specificity of cervicovaginal cytology were 80.6% and 92.6%, respectively. Its positive predictive value and negative predictive value were 93.7% and 77.7%, respectively. The false negative rate was 19.4%. Among 54 false negative cytology cases, they were confirmed by histology as 50 flat condylomas, 2 CIN I, 1 CIN III, and 1 squamous cell carcinoma. The causes of false negative cytology were sampling errors in 75.6% and interpretation errors in 24.4%. The false positive rate was 7.4%. Among 15 false positive cytology cases, they were confirmed by histology as 12 atypical squamous cells of undetermined significance (ASCUS) and 3 low grade squamous intraepithelial lesions (LSIL). The cause of error was interpretation error in all cases. The overall diagnostic accuracy of cervicovaginal cytology was 85.7%.
CONCLUSIONS
Cervicovaginal cytology shows high overall diagnostic accuracy and is a useful primary screen of uterine cervical cancer.
Comparison of Clinical Efficacy between an HPV DNA Chip and a Hybrid-Capture II Assay in a Patient with Abnormal Colposcopic Findings.
Tae Jung Kim, Chan Kwon Jung, Ahwon Lee, Eun Sun Jung, Young Jin Choi, Kyo Young Lee, Jong Sup Park
Korean J Cytopathol. 2008;19(2):119-125.
DOI: https://doi.org/10.3338/kjc.2008.19.2.119
  • 1,706 View
  • 12 Download
AbstractAbstract PDF
This study was performed to compare the efficacy between a DNA chip method and a Hybrid-Capture II assay (HC-II) for detecting human papillomavirus in patients with intraepithelial lesions of the uterine cervix. From May, 2005, to June, 2006, 192 patients with abnormal colposcopic findings received cervical cytology, HC-II and HPV DNA chip tests, and colposcopic biopsy or conization. We compared the results of HC-II and HPV DNA chip in conjunction with liquid based cervical cytology (LBCC) and confirmed the results of biopsy or conization. The sensitivity of the HPV DNA chip test was higher than HC-II or LBCC. The HPV DNA chip in conjunction with LBCC showed higher sensitivity than any single method and higher sensitivity than HC-II with LBCC. We confirmed that the HPV DNA chip test was more sensitive for detecting HPV in cervical lesions than HC-II, and that it would provide more useful clinical information about HPV type and its multiple infections.
Methylation Abnormality in Body Fluid Cytology: A Supplemental Molecular Marker for the Diagnosis of Malignant Mesothelioma.
Joon Seon Song, Jin Kyung Jung, Ji Hye Kang, Ilseon Hwang, Se Jin Jang
Korean J Cytopathol. 2008;19(2):126-135.
DOI: https://doi.org/10.3338/kjc.2008.19.2.126
  • 1,603 View
  • 11 Download
AbstractAbstract PDF
Malignant mesothelioma (MM) is a highly lethal neoplasm arising in pleura and the peritoneum and a rapid and accurate diagnosis is crucial for treatment of the disease. However, the sensitivity of cytological analysis using pleural or ascitic fluid is relatively low, yielding an accurate diagnosis in only 32~79% of cases. We tested the diagnostic value of epigenetic alterations in body fluid cytology as a supplement to conventional methods. Paraffin-embedded tissue blocks from 21 MM patients and associated body fluid cytology slides considered no evidence of malignancy were used to test for epigenetic alteration. Using methylation-specific PCR, we detected methylation of RASSF1A and p16 in 47.6% (10/21) of both surgically resected tumor samples, respectively. Body fluid samples of MM also showed abnormal methylation of RASSF1A and p16INK4a genes in 38.1% (8/21) and 33.3% (7/21) of cases. The concordance in the rates of RASSF1A and p16INK4a gene-methylation abnormalities determined from cytology samples and tissue samples were 61.9% (13/21) and 66.7% (14/21), respectively. Combining both genes increases the sensitivity of the test to 57.1% (12 of 21) of cases. Our results suggest that testing for methylation abnormalities in selected individual genes or gene combinations has diagnostic value as an alternative or adjunct method to conventional cytological diagnosis.
Detecting Malignant Urothelial Cells by Morphometric Analysis of ThinPrep(R) Liquid-based Urine Cytology Specimens.
Bong Kyung Shin, Young Suk Lee, Hoiseon Jeong, Sang Ho Lee, Hyunchul Kim, Aree Kim, Insun Kim, Han Kyeom Kim
Korean J Cytopathol. 2008;19(2):136-143.
DOI: https://doi.org/10.3338/kjc.2008.19.2.136
  • 1,882 View
  • 17 Download
AbstractAbstract PDF
Urothelial carcinoma accounts for 90% of all the cases of bladder cancer. Although many cases can be easily managed by local excision, urothelial carcinoma rather frequently recurs, tends to progress to muscle invasion, and requires regular follow-ups. Urine cytology is a main approach for the follow-up of bladder tumors. It is noninvasive, but it has low sensitivity of around 50% with using the conventional cytospin preparation. Liquid-based cytology (LBC) has been developed as a replacement for the conventional technique. We compared the cytomorphometric parameters of ThinPrep(R) and cytospin preparation urine cytology to see whether there are definite differences between the two methods and which technique allows malignant cells to be more effectively discriminated from benign cells. The nuclear-to-cytoplasmic ratio value, as measured by digital image analysis, was efficient for differentiating malignant and benign urothelial cells, and this was irrespective of the preparation method and the tumor grade. Neither the ThinPrep(R) nor the conventional preparation cytology was definitely superior for distinguishing malignant cells from benign cells by cytomorphometric analysis of the adequately preserved cells. However, the ThinPrep(R) preparation showed significant advantages when considering the better preservation and cellularity with a clear background.
A Study of beta-glucuronidase and Lactic Dehydrogenace Activities in the Neoplastic Tissue of Stomach Carcinoma.
Hee Kyung Chang, Sun Kyung Lee
Korean J Cytopathol. 1985;19(2):141-149.
  • 1,210 View
  • 13 Download
AbstractAbstract 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.
Correlation and Accuracy Between Fine Needle Aspiration Cytology of Thyroid Lesions and Histopathologic Diagnosis: Analysis of 322 Histopathologically Confirmed Cases.
Jaseung Koo, Woo Hee Jung, Seokwoo Yang, SoonWon Hong
Korean J Cytopathol. 2008;19(2):144-151.
DOI: https://doi.org/10.3338/kjc.2008.19.2.144
  • 1,624 View
  • 16 Download
AbstractAbstract PDF
Fine needle aspiration (FNA) cytology is the decisive test in the preoperative diagnostics of thyroid nodules. Here we share our institutional experience about thyroid aspiration and give suggestions for suspicious cytology results. Three hundred twenty-two cases in 270 patients (mean age 47.4 years, 243 women and 27 men) who underwent thyroidectomy were reviewed. Among the 322 cases, the FNA diagnosis of "positive for malignancy" was 87 cases (27.0%), "suggestive of malignancy" 30 cases (9.3%), "suspicious for malignancy" 61 cases (18.9%), "negative for malignancy" 102 cases (31.7%), and "unsatisfactory smear" 42 cases (13.0%). Eighty seven cases (100%) out of "positive for malignancy", 29 cases (96.7%) out of "suggestive of malignancy", and 39 cases (64.0%) out of "suspicious for malignancy" were papillary carcinoma (148 cases, 95.5%), or follicular carcinoma (2 cases, 1.3%), or metastatic carcinoma (1 case, 0.6%). Seventeen patients who had only negative or unsatisfactory cytology underwent thyroidectomy and nine cases (52.9%) were papillary carcinoma. We suggest that: the cytology diagnosis of "suggestive of malignancy" could be regarded as "positive for malignancy", the cytology diagnosis of "suspicious of malignancy" should be carefully correlated with clinico-radiologic manifestation, and even a negative or unsatisfactory smear should be carefully followed up.
An Experimental Study on the Influence of DDVP upon the Kidney.
Kyo Suck Woo, Chong Man Kim, Kook Hwae Koo
Korean J Cytopathol. 1985;19(2):150-155.
  • 1,303 View
  • 11 Download
AbstractAbstract 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.
Cytologic Features of Folliculars Adenoma and Follicular Carcinoma of the Thyroid: A Study on the Likelihood of Cytologic Diagnosis by Fine Needle Aspiration Cytology.
Hee Dae Park, Woon Sun Park, Sun Hee Kim, Seock Hyun Choi, Young Hye Cho, Sung Hee Kang, Kyung Bun Lee, Dong Hoon Kim, Seoung Wan Chae, Jin Hee Shon
Korean J Cytopathol. 2008;19(2):152-159.
DOI: https://doi.org/10.3338/kjc.2008.19.2.152
  • 6,639 View
  • 129 Download
AbstractAbstract PDF
Fine-needle aspiration cytology (FNAC) cannot differentiate follicular adenoma from follicular carcinoma since this distinction can only be based on the presence of capsular or vascular invasion, and this cannot be detected on a cytologic smear. The goal of this study was to define the diagnostic cytologic findings of follicular neoplasm and the possibility of diagnosing follicular neoplasm by performing FNAC. The cases of histologically diagnosed follicular adenoma and follicular carcinoma on the thyroidectomy specimens were retrieved. Among them, the cases with preoperative FNAC that was done within 3 months of the operation were finally selected. Then we reviewed the FNAC and histologic slides of 19 cases: 9 follicular adenomas and 10 follicular carcinomas. Our results suggest that for cases of follicular neoplasm, the aspirates show high or abundant cellularity, frequent follicle formation and occasional cellular atypism of the follicular cells. However, the atypism is more pronounced and more frequently noticed in the cases of follicular carcinoma, which reveals more higher anisocytosis (7/10, 70%), nuclear pleomorphism (9/10, 90%), coarse clumping of chromatin (8/10, 80%) and cellular overlapping (8/10, 80%).
Chronological Observation on Tissue Reaction to Silk Sutures.
Yoon Seong Lee
Korean J Cytopathol. 1985;19(2):156-159.
  • 1,153 View
  • 12 Download
AbstractAbstract 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.
The Diagnostic Accuracy of Fine Needle Aspiration Cytology and the Diagnostic Usefulness of Galectin-3 Immunostaining for the Follicular Variant of Papillary Thyroid Carcinoma.
Chan Choi, Min Cheol Lee, Kyu Hyuk Cho
Korean J Cytopathol. 2008;19(2):160-163.
DOI: https://doi.org/10.3338/kjc.2008.19.2.160
  • 1,542 View
  • 15 Download
AbstractAbstract PDF
The cytologic diagnosis of the follicular variant of papillary thyroid carcinoma (FVPTC) has become one of the common causes of false negative diagnoses when performing fine needle aspiration cytology (FNAC) of the thyroid gland. We retrospectively reviewed all the aspirates for which a diagnosis of FVPTC had been made based on the surgically excised specimens, regardless of the cytologic diagnosis. 145 FNACs was performed in 135 patients. The cytologic diagnoses were categorized as 2 unsatisfactory specimens (1.4%), 16 benign (11.0%), 49 atypical (33.8%) and 78 malignant lesions (53.8%). The tumor cells consistently showed significant nuclear overlapping, irregular nuclei and fine chromatin in all cases; however, nuclear grooves and inclusions were scarce. Galectin-3 immunostaining was performed on the cell blocks of 65 cases and this was positive for 45 cases (69.2%). The results of our study demonstrate that the determination of minimal cytologic criteria is needed to raise the sensitivity of detecting FVPTC by FNAC, and galectin-3 immunostaining is useful to make decisions on the surgical treatment of cytologically atypical thyroid nodules.

JPTM : Journal of Pathology and Translational Medicine