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Volume 25(3); June 1991
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Original Articles
Grooved Nuclei in Thyroid Papillary Carcinoma.
Chang Hun Lee, Kang Suek Suh
Korean J Pathol. 1991;25(3):185-195.
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Recently nuclear grooving has been introduced to be a reliable diagnostic criterion for papillary thyroid carcinoma, in addition to known clear nuclei and intranuclear cytoplasmic inclusions. Now this study is undertaken to assess the diagnostic value of this new clue. The results obtained are as follows : 1) 35 follicullar carcinomas, 106 follicular adenomas and 56 adenomatous goiters were studied as control groups. Grooved nuclei were positive in 22.9% of follicular carcinomas, 19.8% of follicular adenomas and 5.4% of adenomatous goiters, whereas intranuclear cytoplasmic inclusions in 11.4%, 11.3% and 7.1% : and clear nuclei in 22.9%, 23.6% and 5.4%, respectively. 2) Among 105 papillary carcinomas the frequencies of grooved nuclei, intranuclear cytoplasmic inclusions and clear nuclei were 93.3%, 84.8% and 79.0%, respectively. Incidence difference between grooved nuclei and clear nuclei was significantly recognized(p<0.05). 3) Among variants of papillary carcinoma including mixed, pure, occult sclerosing and follicular types, the frequencies of grooved nuclei were 96.7%(59/61), 86.2%(25/29), 100%(13/13) and 50.0%(1/2), respectively. In comparison the frequency of the mixed types was mildly more increased than that of the pure(p<0.05). 4) Among 44 aspiration biopsy cytology cases, which were identified histologically as papillary carcinoma, the frequencies of grooved nuclei and intranuclear cytoplasmic inclusions were 65.9% and 70.5%, respectively. Therefore it is suggested that grooved nuclei be a valuable diagnostic feature of papillary thyroid carcinoma, along with other nuclear findings.
Histopathologic Study of the Endometrium in Primary infertility.
Sung Churl Lim, Jong Boum Choi, Keun Hong Kee, Ho Jong Jeon, Chae Hong Suh
Korean J Pathol. 1991;25(3):196-205.
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This study was performed to fine out the possible causes of primary infertility in female and to provide some diagnostic and therapeutic modalities. A total of 104 cases of endometrium in primary infertility was obtained from the pathology files of Chosun University Hospital and Kwang-ju Christian Hospital during the period of 5 years and 10 months from January, 1984 to October, 1989. The endometrial biopsies were taken on the first of menstruation and classified according to Noyes, Hertig and Rock's criteria. Histologic findings which were compatible with their normal menstrual cycle (premenstrual of late secretory phase and bleeding phase) were noted in 52 cases (50%). Abnormal 52 cases (50%) revealed deficient secretory phase in 36 case (34.6%), proliferative phase in 5 cases (4.8%), irregular proliferation and chronic nonspecific endometritis in 4 cases (3.8%), respectively, endometrial hyperplasia in 3 cases (2.9%), tuberculous endometritis in 2 cases (1.9%), and asynchronous cycle in 1 case (1%). Among the case of dissociated delay was 21 cases (20.2%) and coordinated delay was 15 cases (14.4%). Therefore, deficient secretory phase with dissociate delay was most common abnormal endometrial finding in cases of female primary infertility. The peak age distribution of the female primary infertility in this study revealed 73 cases (63.8%) in patients between the age of 25 and 29. This finding indicated that there was no significant relationship between the age distributions and the endometrial histopathologic findings.
Pathological Study on the Early Gastric Cancer.
Weon Young Choi, Dong Su Suk, Sun Keong Lee
Korean J Pathol. 1991;25(3):206-214.
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Pathological study was performed on the 135 cases (137 lesion) of early gastric cancer (EGC) diagnosed during the period from 1970 to 1988. The gastrectomy specimens were obtained from Pusan National University Hospital and Pusan Paik Hospital. The statistical analysis was applied on the point of pathological and epidemiological aspects. The results obtained were summarized as follows: 1) The proportion of patients with EGC of all gastric cancer diagnosed in Pusan area during the period of 1970 to 1974 was 1.3%, those during 1975 to 1979 was 1.7%, those during 1980 to 1984 was 7.8%, and those during 1985 to 1988 was 20.0% respectively. 2) The model age group was 6th decade in both sexes. The average age of patients with EGC was 50. 1-year-old in men and 47. 9-year-old in women respectively. The sex ratio (M/F) was 2 : 1 but it was lower for young people than for old people. 3) The proportion of sites involved by the EGC in the stomach was as follows : the antrum 61%, the body 39%, and the cardia and fundus 0.01%. The intestinal type cancer more frequently involved the lower portion than the upper portion of the stomach. 4) Regarding the distribution of the gross types of EGC, the elevated group (Type I, IIa) accounted for 14%, the flat type (Type IIb) accounted for 4%, and the depressed group (Type IIc, III) accounted for 82%. There was no correlation between the gross type and the depth of the lesion. The elevated group was more frequent in intestinal type than in diffuse type. 5) The size distribution of the EGC was as follows : 46% of the lesions were smaller than 2.0 cm in diameter, 47% were between 2.1 to 5.0 cm, and 7% were larger than 5.1 cm. There was no correlation between the size of the lesion and the gross type. 6) The intestinal type of EGC was 77 lesions (56.2%) and the diffuse type 60 lesions (43.8%). The ratio of both types (I/D) was 1.3 : 1, and it was lower for younger people than for old people. 7) Ten of 135 cases (7%) had lymph node metastases. The metastatic rate of EGC confined to submucosa was much higher than that of EGC confined to mucosa only, but the metastatic rate was not related with the size of the lesion.
The Effects of Proteolytic Agent on the Lung Injured by Endotoxemia.
Chang Ho Cho, Yoon Kyung Sohn, Jyung Sik Kwak, Tae Joong Sohn
Korean J Pathol. 1991;25(3):215-222.
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The authors studied the lung injury induced by endotoxemia and the effects of proteolytic agent on the lung changed by endotoxemia. Sprague-Dawley rats were intraperitoneally administrated with a single dose of endotoxin (4 mg/kg, E. coli 025 : B6 lipopolysaccharide) or with endotoxin and gabexate mesilate (200 mg/kg), a proteolytic agent, concomitantly. Rats of each group were scarificed at 9, 18, and 27 hours after injection. Light and electron microscopic examination were done. The results obtained were summarized as follows: Light microscopic exmination revealed congested capillaries and neutrophilic infiltration in both groups. Electron microscopic findings were interstitial and alveolar neutrophilic infiltration, endothelial swelling with increased pinocytotic vesicles and cytoplasmic process formation, and interstitial edema. Decrease of osmiophilic bodies in the type II pneumocytes had appeared at 9 hours after endotoxin injection. These changes were increased in severity at 18 hours and 27 hours after endotoxin injection. In the group of concomitant treatment of gabexate mesilated and endotoxin, there was no edema at 9 hours after injection. After 18 hours welling of endothelial cell and interstitial edema had appeared. However, the severity of the edema was markedly decreased. Type II pneumocytes showed well preserved osmiophilic bodies. According to these results, it is considered that administration of gabexate mesilate can significantly redeced the lung injury induced by endotoxemia.
Study on Histopathologic Changes of Suckling Rats Inoculated with Hantaan Virus.
Hye Je Cho, Luck Ju Paek, Ho Wang Lee, Eui Keun Ham
Korean J Pathol. 1991;25(3):223-237.
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Hantaan and related viruses have been implicated as causative agents for a diverse group of human diseases known collectively as "hemorrhagic fevers with renal syndrome" (HFRS). Outbred SD rats obtained within 24 hours after birth were inoculated by intracerebral (the first group) or intramuscular routes (the second group) with 10(9.5)/ml DL50 of Hantaan seed virus suspension in 0.02 ml and 0.1 ml, respectively. Brain, lung, liver, kidney and spleen were used for virus antigen detection by immunofluorecence and histopathologic examination. In the first group, immunofluorescent intensity of virus antigen was increased in all organs (especially brain) and persisted until time of death(day 9). The histopathologic changes were relatively mild in brain and spleen and unremarkable in liver, lung and kidney. In the second group, immunofluorescent intensity of virus antigen was markedly increased in brain until time of death(day 17), but decreased in other organs. The histopathologic findings, such as meningoencephalitis, interstitial pneumonitis with focal hemorrhage, and lymphoid hyperplasia of splenic white pulp were much prominent compared to the first group. However, those of liver and kidney were unremarkable. The chronology of virologic and pathologic findings in Hantaan-infected suckling rats suggests a possible immune-mediated mechanism in disease pathogenesis.
Evaluation of DNA Ploidy of Bronchogenic Carcinomas by Image Analysis.
Soo Sung Kim, Jae Hyuck Lee, Sang Woo Jung, Joo Yong Yoo
Korean J Pathol. 1991;25(3):238-244.
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AbstractAbstract PDF
In order to extract useful tumor cell-specific information. DNA contents and other morphological parameters were measured by image analysis. Single cell preparation was made from archived paraffin blocks of 14 cases of bronchogenic squamous cell carcinoma, poorly differentiated, by protease treatment. The cells were Feulgen stained, and DNA content, area, perimeter, and major axis of the tumor cell nuclei were measured. Inflammatory lymphocytes concurrent with the tumor cells were used as an internal standard. DNA ploidies of the lymphocytes and 2C tumor cells showed simple peaks with Gaussian distribution and mean coefficients of variation of 10% and 14% respectively. By the location and proportion of the tumor cells other than 2C cells, DNA ploidies could be classified into diploidy(1 case), polyploidy(2 cases), and aneuploidy(11 cases). The mean proportion of DNA aneuploidal tumor cells relative to the total tumor cells was 82.8%. In 8 cases, nuclear areas showed more or less overlapped distribution, whereas DNA contents showed discrete peaks. THes results suggest that many bronchogenic squamous cell carcinomas, poorly differentiated, have DNA aneuploidy and high proportion of aneuploidal cells, and that nuclear size and DNA content are more or less independent parameters.
Case Reports
Two Cases of Black Adenoma of the Adrenal Cortex Associated with Cushing's Syndrome.
So Yeon Yu, Youn Wha Kim, Yong Koo Park, Ju Hie Lee, Moon Ho Yang
Korean J Pathol. 1991;25(3):245-249.
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Black adenoma is known to be a rare variant of adrenal cortical adenoma containing characteristic abundant lipofuscin pigments in the cytoplasm. Almost all of them are nonfunctioning and only occasionally they are associated with Cushing's syndrome or primary hyperaldosteronism. We present two cases of black cortical adenoma of the adrenal gland associated with Cushing's syndrome in a 24-year-old woman and a 64-year-old man. This report dealt with clinical and pathologic presentation including ultrastructural identification of lipofuscin pigment.
A Human Case of Hepatic Fascioliasis Accompanied by Egg Granulomas in Common Bile Duct Lymph Node.
Jun Hyuk Choi, Dogn Sug Kim, Won Hee Choi, Tae Sook Lee, Dong Il Chung, Dong Wik Choi
Korean J Pathol. 1991;25(3):250-255.
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AbstractAbstract PDF
A 32-year-old housewife who resides in Taegu was admitted in Yeungman University Hospital due to right upper quadrant abdminal pain of 2 mounths'duration. An abdomical CT and ultrasonography revealed a relatively well demarcated low density mass in the right lobe of liver. Right hepatic lobectomy was performed on the clinical impression of hepatoma. On the light microscopic study, the lobulated liver mass showed extensive central necrosis and fibrosis, with large numbers of pseudotubercles therein. The pseudotubercles have distorted helminthic eggs frequently. The submitted common bile duct lymph node also showed a few pseudotubercles. The eggs recovered from the tissue homogenate measured 140~152 micrometer by 75~85 micrometer in size and were unembryonated and light yellow to brown. The eggs were determined as those of Fasciola species. We reported the present case as 11th one of human fascioliasis in korea.
A Case of Inflammatory Pseudotumor of the Urinary Biadder.
Hye Rim Park, Min Chul Lee, Nack Kyu Choi, Young Euy Park
Korean J Pathol. 1991;25(3):256-262.
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Inflammatory pseudotumor of the urinary bladder is a proliferative spindle cell lesion that microscopically may suggest a sarcoma but that are benign without a recent history of an operation. The first such case was reported by Roth, in 1980, and thereafter about seven more cases were reported in medical literatures. We reported a case of inflammatory pseudotumor of the urinary bladder mimicking leiomyosarcoma. Patient was a 36-year-old woman with complaint of painless total and gross hematuria for 3 weeks. Partial cystectomy specimen showed a well-demarcated nodular mass of yellow white color, involving the submucosal and muscular layers. Microscopic examination revealed proliferating bundles of spindle cells interspersed with infiltration of many inflammatory cells including eosinophils. Spindle cells were positive for vimentin on immunohistochemistry and corresponding to myofibroblasts on the electron microscopic examination.
Pulmonary Alveolar Proteinosis: A case report.
Chang Ho Cho, Yoon Kyung Sohn, Jyung Sik Kwak, Jung Yoon Choi, Won Sik Lee, Tae Hoon Jung
Korean J Pathol. 1991;25(3):263-268.
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A case of pulmonary alveolar proteinosis is reported. Most of the alveolar spaces were filled with amorphous deep eosinohilic material which revealed strong positive reaction to periodic acid-Schiff staining. Electron microscopic observation of this material showed numerous lamellar bodies in the alveolar spaces and cytoplasms of alveolar macrophages. A part of them were concentric multilamellated type A lamellar bodies and the other were finger printlike type B bodies. Combined type A and type B lamellar bodies were rarely present. From the above features it is suggested that both type A and B lamellar bodies could be transformed one another and those lamellar bodies may be originated from pulmonary surfactant.
Pulmonary Lymphangioleiomyomatosis: A case report.
Won Bo Jo, Nam Hee Won, Seung Yong Paik, Hae Kyung Ahn
Korean J Pathol. 1991;25(3):269-274.
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Lymphangioleiomyomatosis(LAM) is a rare disease of women of child-bearing age in which there is progressive hyperplasia of atypical smooth mucle along lymphatics in the lung, and/or axial lymphatics in the thorax and abdomen, resulting in honeycombing of lung. Interestingly there has been a speculation that it represents a forme furste or incomplete expression of tuberous sclerosis complex. This is based on the observation that patients with tuberous sclerosis can manifest pulmonary lesions indistinguishable from LAM. We report a case of LAM occuring in a 39-year-old female, who complained of recurrent pneumothorax, chest pain and shortness of breath. Three years ago, the patient had right nephrectomy under the diagnosis of ruptured angiomyolipoma. A X-ray film of the chest showed honeycombing with a diffusely reticulonodular pattern and cyst-like spaces. She had a characteristic facial appearance of adenoma sebaceum, which her father and uncle had. Microscopically, the lung showed a marked smooth muscle proliferation around the slit-like lymphatic spaces and also some respiratory bronchioles.
Hepatic Candidiasis: A case occurred in a patient with leukemia.
Chan Il Park, Sun Hee Sung, Eun Kyung Han, Ho Guen Kim
Korean J Pathol. 1991;25(3):275-277.
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In view of the possible role of portal circulation in hematogenous spread of Candida species, a case of hepatic candidiasis occurred in an eight-year-old child with acute lymphoblastic leukemia (ALL) treated by chemotherapy is presented. Symptoms and signs referable to the hepatic disease in this patient included hepatomegaly, icteric sclera and abdominal pain. There were no particular manifestations suggestive of deep mycotic involvement of any sepcific organs or tissues other than the liver. Culture of the blood was negative for one month. On the 24th hospital day the patient died with the presumptive diagnosis of ALL, disseminated intravascular coagulation, acute renal failure, pulmonary edema, cholecystitis and oral thrush. A needle necropsy was performed and revealed fungal aggregates replacing the large foci of hepatic cell loss. It is suggested that, when the gastrointestinal tract serves as the portal of entry, the liver could be the visceral organ involved first in the course of disseminated candidiasis.
Ciliated Foregut Cyst of the Liver: Report of a case.
Yun Kyung Kang, Yong Il Kim, Hyun Soon Lee, Soong Duk Lee, Kuk Jin Choe
Korean J Pathol. 1991;25(3):278-280.
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We report a case of ciliated hepatic foregut cyst which was incidentally found in a 64 year-old man. The cyst, 6 cm in diameter, was unilocular, solitary and was located in the medial segment of left lobe, just below the Glisson's capsule. Microscopically, the cyst wall consisted of 4 layers; pseudostratified ciliated columnar epithelium, subepithelial loose connective tissue, smooth muscle bundles and an outermost fibrous capsule. Although cartilage or subepithelial sero-mucous glands were absent, the morphologic features of the cyst correspond with those of an incomplete form of brochogenic cyst.

J Pathol Transl Med : Journal of Pathology and Translational Medicine