Journal of Pathology and Translational Medicine

Volume 26(1); February 1992

Original Articles

Analysis of DNA Ploidy Pattern of Hepatocellular Carcinoma with Comparison between Flow Cytometric and Image Cytometric Study.: Sung Sook Kim, Seok Gun Park, Dong Sun Han, Man Ha Huh; Korean J Pathol. 1992;26(1):1-9.

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Abstract PDF: Fifty cases of hepatocellularcarcinoma were studied using retrospective flow cytometric(FCM) and image cytometric(ICM) DNA analysis to determine the prevalence of aneuploid cell population and whether they were associated with any particular clinico-pathologic findings. At the same time, we compared the difference between FCM and ICM. The materials were prepared from 50 micrometer cut of paraffin embedded blocks. The DNA modal values, which could be defined in 42 cases by FCM with 74% aneuploidy and in 50 cases by ICM with 76% aneuploidy. So 95% of the cases had concordant DNA ploidy results by both techniques of FCM and ICM. Abnormal DNA pattern was correlated with age(<50), presence of cirrhosis, pathologic grade and some pathologic types(p<0.05), but was not correlated with presence of HBsAg, sex, alphafeto protein, and alcohol history(p>0.05). Also we found that ICM technique was easier to perform and interprete.

Pseudolipomatosis of the Gastrointestinal Mucosa: Report of 6 cases with analysis of possible factors involved during endoscopic procedure.: Ghee Young Choe, Yong Il Kim, Kyoo Wan Choi, Kee Suk Hong; Korean J Pathol. 1992;26(1):10-16.

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Abstract PDF: Pseudolipomatosis of the colonic mucosa has been recognized as a lesion featured with aggregations of gaseous spaces in the lamina propria, but its pathogenesis remains still unclear. This paper describes 6 cases of pseudolipomatosis occurring in the mucosa of stomach and large intestine, and the possible factors involved in gastrointestinal endoscopic procedure to produce gaseous entrapment in the lamina propria were analysed. All cases received either gastroscopy or colonoscpy before endoscopic biopsy. Mucosal tissues from both stomach and recto-sigmoid colon revealed multiple aggregations of small air-spaces resembling fatty infiltration in the lamina propria. Rarely were similar infiltrations within the muscularis mucosae and adjacent lymphoid follicles. Evidence for pneumatosis cystoides intestinalis or ulcerative colonic lesion was not associated, although one showed a small gastric ulcer nearby. Repeated inflations and deflations of the stomach or colon during the endoscopic procedure with miner mechanical trauma by instrument to the mucosa seem to contribute to its pathogenesis.

Pathologic Classification of the Resected Gastric Carcinoma.: Gu Kang, Hyung Sik Shin, Min Chul Lee, Young Euy Park, Joo Seop Kim, Chul Jae Park, Soo Tong Pai; Korean J Pathol. 1992;26(1):17-27.

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Abstract PDF: A total of 212 cases of gastric carcinoma resected at Kang-Dong Sacred Heart Hospital during the period of 4 years from December 1986 to December 1990 were examined according to Borrmann, Mulligan-Rember, Ming and WHO methods based on histopathological investigations. In Mulligan-Rember (M-R) classification, intestinal cell type (IC) was frequently seen in Borrmann type I and II; pyloro-cardiac gland cell type (PC) in II and III, and mucous cell type (MC) in IV and III. Expanding growth pattern was more frequent in IC, infiltrative growth pattern in MC, and PC showed less infiltrative growth than MC. In gross type, the most expanding growth pattern was seen in Advanced gastric carcinoma type (AGC) I and the next one was in AGC II; the ratio of infiltrative versus expanding type was highest in AGC IV and next in AGC resembling early gastric carcinoma (EGC) and AGC III in order. On WHO classification except squamous type, all the papillary type showed expanding growth and infiltrative growth was frequently seen in signet-ring cell, undifferentiated, tubular and mucinous types in order. Lymphoid stroma was more frequently found in expanding type than infiltrative type. The frequency of angioinvasion of tumor cells observed was high in AGC resembling EGC, AGC II, III, IV, I and EGC in order. In WHO classification excluding squamous type, undifferentiated and signet-ring cell types occurred more frequently under the age of 60 and papillary type were more frequnetly seen over the age of 60. But tubular type had no difference between the two age groups. In Ming's classification, expanding type was more frequently seen than infiltrative type over the age of 60.

Light Electron Microscopic Study in Rat Livers Following Cadmium Chloride Administration.: Kwan Kyu Park, Young Ho Kim, Kun Young Kwon, Eun Sook Chang, Moo Ung Chang; Korean J Pathol. 1992;26(1):28-39.

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Abstract PDF: This study was carried out to investigate the light and electron microscopic findings of the livers of rats after an intraperitoneal injection of cadmium chloride. The Sprague-Dawley rats were intraperitoneally injected with cadmium chloride dissolved in water, once a day for three days. These animals were sacrificed at 1, 3, 8, and 24 hr after the last injection. Control groups of the rats were also sacrificed in the same manner. The liver was extirpated and examined by both light and electron microscopy. The results obtained are as follows: The parenchyma of the liver shows focal neutrophilic infiltration and spotty necrosis. The hepatocytes show fatty change, ballooning degeneration, swelling of the endoplasmic reticulum and mitochondria, increase numbers of secondary lysosomes and residual bodies. Focal patic venules and sinusoids of the liver are congested. The Kupffer cells are increase in number. Therefore, it can be concluded that the cadmium is directly acted to hepatocytes resulting in cellular injuries and deposits in the fat droplets of the cytoplasm of the hepatocytes, not Ito cells as previously suggeted.

Immunohistochemical and Ultrastructural Cellular Differentiation in Papillary and Solid Epithelial Neoplasm of the Pancreas.: Jae Hyuck Lee, Min Cheol Lee, Chang Soo Park, Kyu Hyuk Cho; Korean J Pathol. 1992;26(1):40-52.

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Abstract PDF: Papillary and solid epithelial neoplasm of the pancreas from five patients were studied using immunohistochemistry and electron microscopy to define the cellular origin of this type of tumor. The tumors ranged in diameter form 5.5 to 15 cm Grossly, these were well circumscribed by a firm, gray-white, fibrous capsule and their cut-surface showed mainly area containing mucinous substance with necrotic and hemorrhagic material, with some solid portion. Microscopically, there was a solid and papillary pattern, with uniform cells typically having round to ovoid nuclei containing indistinct nucleoli and eosinophilic, granular cytoplasm. Within the cytoplasm of the tumor cells, numerous PAS-positive granules were found. Immunostaining was positive for neuron-specific enolase(three of five cases), alpha1-antitrypsin and alpha1-antichymotrypsin(three of five cases) in the solid and papillary portion of the tumor. But no polypeptide hormone immunoreactive cells were present in all cases except for gastrin which showed focally weak positivity in the papillary area. Ultrastructurally, the papillary and solid epithelial neopasm of the pancreas showed evidence of acinar cell differentiation, because in the cell of one observed some zymogen-like granules and presence of annulate lamellae. But also, abundant typical neurosecretory granules were detected in the tumor cells ultrastructurally. Both facts suggested acinar and islet cell differentiation of the tumor. From the these findings, it concluded that papillary and solid epithelial neoplasm of the pancreas may be originated from a primordial cell which will be able to render both endocrine and exocine component.

Placental Site Nodules & Plaques: A clinicopathologic analysis of 14 cases.: Kyu Rae Kim, Sun Won Hong, Kyung Sub Cha, In Pyong Kwak, Tae Ki Yoon; Korean J Pathol. 1992;26(1):53-61.

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Abstract PDF: Placental site nodules and plaques have been recently described to designated single or multiple, well-circumscribed, rounded lesions at the placental site, composed of viable or degenerating intermediate trophoblastic cells and extensive hyalinization between the cells. We described clinicopathologic findings of 14 cases of placental site nodules and plaques. The age of 14 patients ranged from 25 to 39(average 33) years and all of them had been pregnant in the past. Ten of them presented with vaginal spotting, which was preceded by recent pregnancy in only 3 cases. Three patients presented with secondary infertility and one with secondary infertility and vaginal spotting. Urine pregnancy tests were negative in all 14 cases at the time of presentation. Ultrasonographic examination disclosed abnormalities in only 3 cases and the remaining cases were normal. Hysterosalpingography was performed in 3 patients who presented with 2 degrees infertility and revealed moderate to severe intrauterine adhesions. Microscopically, chronic endometritis of varying degrees evidenced by plasma cells and eosinophiles were present in all cases and these were more prominent in the vicinity of the lesions. It is presumed that the placental site nodules and plaques are not sloughed at the time of menstruation and it may cause chronic endometritis or intrauterine adhesions at any time after previous delivery.

Epidermolysis Bullosa Simplex Generalisata.: Kye Yong Song, Joong Seok Seo, Sung Hye Park, Je G Chi, Kwang Hyun Cho; Korean J Pathol. 1992;26(1):62-65.

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Abstract PDF: We report a case of epidermolysis bullosa simplex occurred in a 12-year-old girl, who presented with intractable bullous lesions of the hands and feet after minor traumas ever since her early neonatal period. The bullous lesions were noted on the 2nd and 4th webs of the fingers and dorsum of the hands as well as on the skin of the ankle. The lesions were healed without scar formation. Family history was not contributary and seasonal pattern was not noted. Histologic sections revealed intraepidermal bullae just above the well preserved basement membrane. Electron microscopic findings revealed cytolysis of basal cells with preservation of the basement membrane, indicating the epidermal type of epidermolysis bullosa simplex.

Case Reports

Primary Malignant Hemangiopericytoma of the Lung: A case report.: Jung Hee Kang, Eun Kyung Hong, Chan Keum Park, Jung Dal Lee; Korean J Pathol. 1992;26(1):66-70.

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Abstract PDF: Primary pulmonary hemangiopericytoma is a rare, potentially malignant tumor and assumes more malignant course than that originated in the soft tissue. It can be asymtomatic until attaining a large size within the lung. We report a case of malignant hemangiopericytoma of the lung in a 29 year old man. It represented as a sharply demarcated, huge homogeneous opaque mass in the right upper lobe. The cytologic and histologic features were that of malignant hemangiopericytoma.

Agenesis of the Dorsal Pancreas: An autopsy case.: Won Sang Park, Ki Hwa Yang, Seok Jin Kang, Byoung Kee Kim, Sun Moo Kim; Korean J Pathol. 1992;26(1):71-75.

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Abstract PDF: Agenesis of the dorsal pancreas is one of the rare congenital anomalies of the pancreas. Six cases of them have been reported. We have experienced an autopsy case of agenesis of the dorsal pancreas associated with fetal death in the uterus. Grossly, the body and tail of the pancreas and uncinate process were not found and those were partially replaced by adipose tissue. No abnormality was noted in the other organs. Microscopically, pancreatic tissue with autolytic change was identified only in the head portion of the pancreas.

Original Articles

Epithelial-Myoepithelial Carcinoma of Intercalated Duct of Parotid Gland.: Soong Deok Lee, Doo Hyun Chung, Sung Hye Park, Chul Woo Kim, Je G Chi; Korean J Pathol. 1992;26(1):76-81.

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Abstract PDF: Epithelial-myoepithelial carcinoma of intercalated duct(origin) is a recently described tumor characterized by its typical biphasic pattern of central duct like cell and peripheral clear cell. We described a case of epithelial-myoepithelial carcinoma in a 10-year-old boy. Microscopically, the tumor showed typical biphasic pattern, diffuse proliferation of clear cells and linining epithelial cells of tubular structures. Immunohistochemically, the clear cell showed positive reaction to S-100 protein, and the epithelial cells expressed cytokeratin indicating myoepithelial and epithelial differentiation respectively. Biphasic differentiation of the tumor cells could be also proved by electronmicroscopic study.

Sebaceous Gland Tumor Arising in Cystic Teratoma of the Ovary: An unique form of monodermal teratoma.: Dae Joong Kim, So Young Jin, Dong Wha Lee; Korean J Pathol. 1992;26(1):82-87.

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Abstract PDF: Although cystic teratoma is the most common benign tumor of the ovary, the association of sebaceous gland tumor with cystic teratoma is rare. We have recently experienced a case of sebaceous gland tumor, arising in the cystic teratoma of the ovary in a 78-year-old Korean woman. Histologically, the tumor was characterized by an organoid lobular architectures of the sebaceous glands which are exculsively composed of germinative and mature sebaceous cells. Although it is difficult to come to a valid conclusion due to the presence of atypical mitosis and necrosis, this tumor was regarded as benign from the viewpoint of preserved organoid structures, and absence of capsular invasion or metastasis.

Case Report

Pulmonary Lymphangiomyomatosis: A case report.: Mi Seon Lee, Kwang Sun Suh, Kyoung Joo Lee; Korean J Pathol. 1992;26(1):88-91.

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Abstract PDF: Pulmonary lymphangiomyomatosis is a rare disease of haphazard overproliferation of smooth muscle from perilymphatics, peribronchial and perivascular regions of the lung that leads to chylous effusion, hemoptysis, spontaneous pneumothorax and pulmonary insufficiency. The disease only affects women of child-bearing age. There is presently no successful therapy and most of the patients die within 10 years of diagnosis. We experienced a case of pulmonary lymphangiomyomatosis in a 30-year-old woman who had suffered from three episodes of spontaneous pneumothorax for 4 years. Open lung biopsy was performed. Microscopically, abnormal excess proliferation of smooth muscle tissue was identified in the wall of perivascular lymphatic channels as well as around small bronchi, and more distal air spaces. Varying sized cytic spaces Iined by cuboidal cells were also present. Tamoxifen, given if February 1991, did not influence the course of her disease. She died of respiratory failure at age of 31 in April 1991.

Original Article

Spinal Neurenteric Cyst of Foregut Origin.: Gyeong Hoon Kang, Je G Chi; Korean J Pathol. 1992;26(1):92-97.

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Abstract PDF: The neurenteric cyst with associated anomalies is the result of an ectoentodermal communication that exists during embryogenesis. The variety of lesions include intraspinal cysts, congenital vertebral deformities, thoracic cyst, malformations of the digestive tract, and occasionally, dysrhaphias of the sinodermal or myelomeningocele type. A case of intraspinal neurenteric cyst in a 3-year-old boy is presented. He presented with cyclic abdominal pain, fever and constipation of 30 days' duration. These symptoms progressed rapidly into gait disturbance and left hemiplegia. A single epithelial cyst, located ventral to the spinal cord in the lower thoracic region, traversed the cleft of spina bifida of thoracic vertebrae and connected to retromediastinal cyst. The inner cyst wall was lined with pseudostratified ciliated epithelia and a few squamous cells. The cyst wall contained well-developed muscle coat, myenteric plexuses, and scattered seromucinous glands.

Case Report

Basaloid-Squamous Carcinoma of the Esophagus: A case report.: Tae Jung Jang, In Joon Choi; Korean J Pathol. 1992;26(1):96-98.

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Abstract PDF: Basaloid-squamous carcinoma of the esophagus is rare and similiar to the solid type of adenoid cystic carcinoma of the salivary gland. The origin of this tumor is unknown. The tumor was located in the lower third of the esophagus. The case of basaloid-squamous carcinoma consisted of submucosal tumor showing carcinoma with a basaloid pattern and focal squamous differentiation associated with squamous cell carcinoma or carcinoma in situ of the esophageal mucosa. A few submucosal tumor cells were positive for cytokeratin.

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