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Volume 21(3); September 1987
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Original Articles
Mechanisms of Experimental Pulmonary Fibrosis Following Paraquat Toxicity.
Sang Sook Lee, Chai Hong Chung, Tae Jung Sohn
Korean J Pathol. 1987;21(3):111-137.
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AbstractAbstract PDF
This study was carried out to investigate the intricate mechanisms of intraalveolar fibrosis, leading to the alveolar structural remodeling, of rat lungs treated with paraquat. Sixty-three male Sprague-Dawley rats, maintained on a stock diet, weighing 200.0 gm, average, were divided into 4 experimental groups. Group 1. Control group (10 rats). Intraperitoneal injections of 2-4 ml normal saline only. Group 2(13 rats). 10, 20, 25, 30 and 40 mg per kg of body weight was administered intraperitoneally. Animals were sacificed 5 hours. 1 and 3 days after paraquat treatment. Group 3(16 rats). 20, 25, 30 and 40 mg per kg of body weight was administered to the animal, and animals died 2-5 days after paraquat administration. Group 4(24 rats). The same amount of paraquat was administered to the animal as in the group 2. Animals were sacrificed 1, 2, 6, 8 and 10 weeks after paraquat treatment. Sacrificed animal lung was examined by gross, light-microscopic, immunohistochemical, ultrastructural observation, along with cellular and chemical analyses of bronchoalveolar lavage fluid. The results were as follows: Grossly, 6 rats of chronic stage (1-10 weeks survival) developed multiple wedge-shaped scars on both lungs. These scars were situated mainly along the bronchial trees, blood vessels and subpleural regions. Light microscopically, the salient features found of the chronic stage lungs were intraalveolar fibrosis. Intraluminal buds or polypoid masses projecting into the alveolar lumen and ducts. Elsewhere, loose connective tissue masses were found to fuse together to alveolar wall, obliterating the alveolar spaces with resultant severe alveolar structural remodeling. Immunohistochemically, fibronectin was found in the center of intraalveolar buds and polypoid mass, projecting into the alveolar lumen, and in the adjacent proliferating alveolar macrophages. An attempt to measure the amount of fibronectin in the bronchoalveolar lavage fluid failed. Electron microscopically, the chronic stage lung revealed marked proliferation of both alveolar macrophages and fibroblasts in the alveolar spaces, the latter containing actin-like microfilaments and collagen fibers arranged in bundles and spirals. In areas, myofibroblasts and smooth muscle cells also present. Cellular analysis of the bronchoalveolar lavage fluid in chronic stage lungs revealed no significant findings. It can be concluded, therefore: That intraalveolar fibrosis of the paraquat-treated lungs of the rat is probably mediated by intraalveolar migrations of the interstitial cells, the main task force being the connective tissue cells, passing through the defects created in the epithelial lining surface to its basement membrane, which were inflicted upon the alveolar wall by paraquat toxicity. Fibronectin, released by activated alveolar macrophages, may be responsible for the migrations of fibroblasts and myofibroblasts into the alveolar spaces to form the intraalveolar fibrosis with subsequent alveolar structural remodeling,
Immunohistochemical Demonstration of Fibronectin in Paraquat-Induced Interstitial Fibrosis of Adult Human Lung.
Seung Pyo Hong, Sang Sook Lee, Chai Hong Chung
Korean J Pathol. 1987;21(3):138-143.
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AbstractAbstract PDF
We studied distribution of fibronectin in paraquat-induced adult fibrotic lung by indirect immunofluorescence and indirect immunoperoxidase methods, using affinity-purified antifibronectin IgG peroxidase conjugates and antifibronectin IgG FITC conjugates. In contrast to the relative paucity of staining in normal lung, there was a marked increase in interstitial staining for fibronectin in this fibrotic lung. This marked alterations in the apparent amounts and distribution of fibronectin in fibrotic human lung suggest its involvement in the cellular events accompanying human lung fibrosis.
Immunohistochemical Characterization of the Salivary Gland Tumors.
Jung Hoon Yoon, So Young Jin, Chan Il Park
Korean J Pathol. 1987;21(3):144-152.
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AbstractAbstract PDF
It has been clarified that myoepithelial cells contain S-100 protein which is known to be a marker protein of neural tissue. To evaluate the participation of myoepithelial cells in the histogenesis of the salivary gland tumors, normal salivary glands and various salivary gland tumors were stained by immuno-peroxidase method. PAP kits (DAKO Co, USA) for the S-100 protein and the Cytokeratin were used and the following resulting were obtained. Acinic cells of the normal salivery gland were negative for both cytokeratin and S-100 protein. The intercalated duct cells were weakly positive for cytokeratin and S-100 protein. The normal myoepithelial cells scattered around the acini and the intercalated ducts were positive only S-100 protein. In contrast, the striated duct were positive only for cytokeratin. In plemorphic adenoma, the S-100 protein positive cells were found in solid sheets of tumor cells, in chondromyxoid areas and in areas of spindle-cell stroma as well as in the outer layer of the tubular structures. Only the inner lining of the tubules were positive for cytokeratin. In basal cell adenoma, the stromal spindle cells were strongly positive for S-100 protein and the epithelial cells weakly positive. When tubules were present within the epithelial sheets, the inner most lining cells were positive for cytokeratin. The peripheral palisaded tumor cells were negative for both substances. By immunostaining of the adenoid cystic carcinoma, S-100 protein containing cells were found focally scattered independently on the variety of histologies. The lining cells of true cystic structure were positive for cytokeratin. Immunostaining of the mucoepidermoid carcinoma demostrated that the squamous cells and the tubular epithelial cells contained cytokeraitn, whereas only a few intermediate cells were positive for S-100 protein. In Warthin's tumor there were no S-100 protein positive cells, although basally located epithelial cells of the papillae were positive for cytokeratin. These findings suggest that salivary gland tumors other than the Warthin's tumor arise from myoepithelial cells or reserve cells having dual potentiality differentating into myoepithelial and intercalcated duct cells.
Histopathological and Immunohistochemical Studies of Primary Gastrointestinal Lymphomas in Korean Patients.
Soon Hee Jung, Hyen Joo Jeong, Woo Hee Jung, Tai Seung Kim, In Joon Choi
Korean J Pathol. 1987;21(3):153-167.
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AbstractAbstract PDF
The present study is aimed to investigate the clinical and pathologic features of GI lymphomas and the immunocytochemical characteristics, using 71 cases of primary GI lymphomas examined at the Department of Pathology, Yonsei University College of Medicine, Youngdong Serverance Hospital and Yonsei University Wonju College of Medicine from January, 1976 to December, 1985. Results obtained were as follows: 1) Sixty eight cases were Non-Hodgkin's lymphoma and 3 Hodgkin's lymphoma. Surgical resection was done in 58 patients and surgical biopsy in 13. 2) The primary sites of the tumors were stomach, small intestine, ileocecal area and large intestine in a descending order of frequency. 3) The mean age at the time of diagnosis was 45 years. The tumor of the small intestine was generally detected in the younger age and that of the large intestine in the older age. The overall male to female ratio was 1.9 : 1. 4) Abdominal pain was the most common presenting symptom irrespective of the sites of the tumor. Duration of the symptoms were evenly distributed from hours to 12 monthes. 5) The size of the tumors was less than 10 cm in the largest dimension in most of the cases (79.3%). The gross types of the GI lymphomas were ulcerative (27.6%), polypoid (20.7%), multinodulated (17.2%) and diffuse thickening. The rate of lymph node involvement was 44.4% in tumors confined to the serosa, while 82.6% in tumors with serosal penetrations. 6) Classification of 68 cases of Non-Hodgkin's lymphoma according to Working Formulation revealed 50 cases of intermediate grade, 13 cases of high grade and 5 cases of low grade. According to Rappaport classification, all were diffuse types, among which diffuse histiocytic type was the most common. According to Lukes-Collins classification, 60 cases were B cell types, 4 cases genuine histiocytes types and 3 cases T cell types. Most of the gastric and intestinal lymphomas belonged to the follicular center cell (small and large cleaved, large cleaved) types. 7) Immunoperoxidase stains were done in 55 cases of malignant lymphomas. Thirty (65.9%) of 47 B cell lymphomas revealed a positivity for B cell markers. Twenty three (48.9%) of them showed a monoclonality, in which kappa/IgG pattern was most frequently demonstrated. Four cases of true histiocytic lymphomas were positive for alpha-1-antichymotrypsin and lysozyme, the former of which was seemed to be a more sensitive marker for histiocytic differentiation. An attempt was made to evaluate the significance of the degree of reactive histiocytic infiltrates within the lymphoma in relation to the progosis, but correlation could not be made because of the limited cases.
Korea University Laboratory Data Management and Communication System III-Pathology (KULAB III).
Kap N Lee, Seung Y Paik
Korean J Pathol. 1987;21(3):168-175.
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AbstractAbstract PDF
This pathology laboratory data management system is developed at the department of pathology and laboratory medicine, College of Medicine, Korea University, as an extension of Korea University laboratory Data managment and communication system. This is built in hospital computer for business, with the connection to the hospital business information system by software. The pathology department is only using terminals and printers, which enables us to maintain the lowest cost to maintain and operate the system. It has been written in COBO1 and utilized TOTAL Data Base and SNOMED (microglossary for surgical pathology). The input keys include patient hospital registration number, laboratory test code and SNOMED code or direct English written diagnostic words through dual masters of SNOMED.
Gastric Phycomycosis Presenting as an Ulcerative Lesion within the Early Gastric Carcinoma.
Myung Sook Kim, Kwang Yun Kim, Yong Il Kim
Korean J Pathol. 1987;21(3):176-184.
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AbstractAbstract PDF
Primary phycomycosis of the stomach within the ulcerative portion of early gastric carcinoma is presented in a sixty one year old male alcoholics. In the center of IIc type submucosal adenocarcinoma was a large deep ulcer (UL-IV) which was the only seat of phycomycetes infection accompanied with angioinvasion and exudative endovasculitis aside from unusual granuloma formation with Splendore Hoeppli phenomenon and eosinophilic response as in allergic granulomatous aspergillosis. The above features were reconstructed to indicate that the phycomycetes infection was confined to the type III area of IIc + III early gastric carcinoma, and that the local ulcerogenic lesion seems more contributory in its development than systemic factors including gastric carcinoma per se or alcoholic consumption.
Case Report
Secondary Biliary Cirrhosis in A Case with Intraductal Growth of Hepatocellular Carcinoma.
Hyung Geun Song, Yong Il Kim, Chung Yong Kim, Soo Tae Kim
Korean J Pathol. 1987;21(3):185-191.
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AbstractAbstract PDF
A case of hepatocellular carcinoma (HCC) complicating with secondary biliary cirrhosis due to intrahepatic bile duct growth of the tumor is presented. The patient was 34 years-old male who had been suffered from right upper quadrant pain with intermittent fluctuating jaundice for 4 months. Left lobectomy specimen contained a single, 4 cm sized, relatively well circumscribed and partly protruding nodular HCC in the medial seqment of left lobe. It compressed the left hepatic duct, and the intra and extra-hepatic ducts were completely plugged with tumor casts (extending to the common bile duct at the operating table). Remaining hepatic parenclyma was the seat of advanced secondary biliary cirrhosis in which were abundance of HBsAg-containing hepatocytes possibily representing a HBsAg carrier status. Biliary cirrhosis in HCC is an extremely rare manifestation, reflecting the delayed adequate clinical procedure by unusual pattern of obstructive jaundice. In such a case presenting as persisting and fluctuating obstructive jaundice in HCC, an intrabile duct tumor growth should be suspected.
Original Articles
Two Histologic Variants of Giant Cell Carcinoma of the Pancreas.
Hyung Geun Song, Yong Il Kim, Eun Sil Yu, Hyun Soon Lee
Korean J Pathol. 1987;21(3):192-198.
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AbstractAbstract PDF
Two cases of unusual giant carcinoma of the pancreas are presented. Each presented with a large tumor mass with or without cystic change, either in the head or tail portion of the pancreas. A pleomorphic gaint cell carcinoma variant (case 1) differed from an epulis type (case 2) with nuclear atypism of giant cells, but widespread metastasis in both cases reflected the accountability of spindle cell element as an important parameter for the determination of their biological behavior.
Carcinoma In Situ of the Urinary Bladder with Transitional Cell Carcinoma of Prostate: A Histopathologic Study and Mapping of the Urothelial Lesions.
Seung Pyo Hong, Sang Sook Lee, Chai Hong Chung
Korean J Pathol. 1987;21(3):199-206.
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AbstractAbstract PDF
A 63-year-old male patient with extensive carcinoma in situ of the urinary bladder was found to have unsuspected transitional cell carcinoma of the prostate. Mapping of the totally embedded radical cystectomy specimen demonstrated diffuse, multifocal, epithelial abnormalities, ranging from mucosal atypia to the nonpapillary carcinoma in situ with extension to the urethra, prostatic ducts and glands, seminal vesicles and ureter, probably reflecting individual urothelial susceptibility in reaction to carcinogenic stimulus. The importance of prostatic assessment in the evaluation of the patient with carcinoma in situ of the urinary bladder is emphasized.
Case Report
Multiple Proliferating Trichilemmal Tumors with Ordinary Trichilemmal Cysts: A case report.
In Sook Kim, Jin Hee Sohn, Hye Seon Ahn, Jung Il Suh, Hyo Sook Park, Soo Jo Kim, Sook Ja Sohn
Korean J Pathol. 1987;21(3):207-213.
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AbstractAbstract PDF
Proliferating trichilemmal tumor is one of rare benign tumors of the skin appendages, considering as hamartoma of the terminal hair follicle, isthmic segment of the outer root sheath. We report a case of numerous proliferating trichilemmal tumors admixed with ordinary trichilemmal cysts with femilial history in 64-year-old man. He has total 157 lesions, which are chiefly located in scalp (48), back (32), and also face, neck, trunk, extremities. Histologically, the tumor is composed of irregularly arranged and ansatomosed trabeculae, lobules, or sheets of proliferated trichilemmal squamous epithelium with peripheral palisading of the basaloid cells. Several layers of squamoid or ovoid cells have PAS-positive clear cytoplasm. And it also shows abrupt amorphous, trichilemmal keratinization. Some squamous eddies with mild cellular atypism are associated, but definite invasion or other evidence of the malignancy is not found. usual multiple trichilemmal cysts are admixed with tumor and occasionally exhibit connection between them.

JPTM : Journal of Pathology and Translational Medicine