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Volume 35(1); February 2001
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Original Articles
Altered Fhit Expression and Its Relationship with p53 Overexpression in Non-small Cell Lung Cancers.
Na Hye Myong, Seok Jun Yoon
Korean J Pathol. 2001;35(1):1-6.
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AbstractAbstract PDF
BACKGROUND
FHIT (Fragile histidine triad), the tumor suppressor gene at 3p14.2, encompasses the FRA3B fragile site and is a common target of deletions in primary human epithelial cancers, including those of the lung, head and neck, stomach, cervix, breast, and kidney. We investigated the association of Fhit expression with clinicopathologic features, including smoking history, and tried to correlate its altered expression with p53 overexpression in 45 non-small cell lung cancers.
METHODS
Immunohistochemical staining was performed on the paraffin sections, using primary anti-GST-Fhit and anti-human p53 antibodies. A four-tiered scoring system, incorporateing both intensity of staining and the percentage of cells stained was used. Composite scores < or = 3 were defined as a marked reduction or loss of Fhit or p53 protein expression.
RESULTS
Among the 45 tumors analyzed, 35 (77.8%) were markedly reduced or negative for Fhit protein expression. The reduced expression of Fhit protein was found to be significantly higher in smokers than in nonsmokers and also higher in squamous carcinoma compared with adenocarcinoma. Fhit and p53 alterations were found to be independent events, because there was no significant difference of Fhit-negativity between p53-positive and -negative groups.
CONCLUSION
These results indicate that the Fhit alteration preferentially occurs in smokers and in the squamous type of non-small cell lung carcinomas. In addition, the results support the notion that Fhit alterations play an important role in the pulmonary carcinogenesis.
Expression of Chromogranin A, Cathepsin D, Cyclin D1 and p53 proteins in Colorectal Adenocarcinoma.
Chae Hong Suh, Mi Ja Lee, Sung Kang Cho
Korean J Pathol. 2001;35(1):7-13.
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AbstractAbstract PDF
BACKGROUND
The purpose of this study is to assess the roles of chromogranin A, cathepsin D, cyclin D1 and p53 protein expression in colorectal tumorigenesis.
METHODS
83 colorectal cancer and 12 villotubular adenoma tissue specimens were investigated by immunohistochemical staining for chromogranin A, cathepsin D, cyclin D1 and p53 protein. Clinicopathologic values (tumor size, histologic grade, Astler-Coller stage and lymph node metastasis) were compared with the incidence of chromogranin A, cathepsin D, cyclin D1 and p53 protein expression in colorectal adenocarcinomas.
RESULTS
Statistically significant correlation was noted between the expression of chromogranin A and histologic grade (p<0.05). The incidence of positive cathepsin D expression was increased with tumor size (p<0.05), and there was a statistically significant correlation between histologic grade and cathepsin D expression (p<0.005). There were no statistically significant correlations among cyclin D1 expression and tumor size, histologic grade, stage and lymph node metastasis. Patients with lymph node metastasis had a high incidence of positive p53 protein expression compared to those without this finding (p<0.001).
CONCLUSION
It is suggested that chromogranin A, cathepsin D, and p53 protein are useful variables for the prognostic assessment of colorectal adenocarcinoma. The p53 protein seems to involve the metastatic ability of colorectal adenocarcinomas. Also, the expression of cathepsin D, cyclin D1, and p53 protein may play an important role in the tumorigenesis and progression of the colorectal adenoma-carcinoma sequence.
Does the Colorectal Cancer Among Koreans Share the Same Pathological Features by Geographical Distribution: A Nationwide Survey of Surgically Resected 1,676 Cancers from 1,602 Patients.
Mee Soo Chang, Jin Hee Sohn, Dae Young Kang, Gyeong Hoon Kang, Myung Sook Kim, Woo Ho Kim, Jong Hee Nam, Woo Sung Moon, Sun Hoo Park, Cheol Jeun Park, Ro hyun Sung, Young Lyun Oh, Eun Sook Chang, Hee Kyung Chang, Mee Yon Cho, Kyung Ja Cho, Yong Il Kim
Korean J Pathol. 2001;35(1):14-19.
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AbstractAbstract PDF
BACKGROUND
This nationwide survey was undertaken to characterize the general pathological features of colorectal cancer in Korea, and especially to elucidate the geographical characteristics by means of their anatomical distribution.
METHODS
We analysed 1,676 colorectal cancers (from 1,602 patients) surgically resected in 1998 at 15 institutions from nine geographical sites in Korea.
RESULTS
The topographic incidence of colorectal cancer in seven out of the total nine geographical sites, was the highest in the rectum (32-54%); and those from Wonju and Cheongju were in the sigmoid colon (28% for both). The right colon cancer incidence was 42% in Wonju and 36% in Cheongju, while it was 17-22% in the other areas. The cecal cancer incidences in Wonju and in Taegu were 7% and 8%, respectively, but 0-4% in the other areas. As for histology, moderately differentiated adenocarcinoma was the most frequent (46-84%), except for in Wonju and Chonju, where the most predominant type was well differentiated (63% and 52%, respectively).
CONCLUSION
The incidence of right colon cancer was higher in Wonju and Cheongju, than in the other geographical sites. The cecal predilection was prominent in Taegu and Wonju. The Elucidation of geographical differences in degree of differentiation for tubular adenocarcinoma seems to require further cumulative study with strict guidelines.
The Observation of Histologic Changes of Major Intrahepatic Bile Duct Epithelium in the Resected Liver Tissue with Hepatolithiasis.
Woon Sup Han, Sae Kyung Choi, Sun Hee Sung
Korean J Pathol. 2001;35(1):20-25.
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AbstractAbstract PDF
BACKGROUND
The relationship between hepatoliths and cholangiocarcinoma is etiologically unclear. However, histogenetic sequencing with hyperplasia, dysplasia and carcinoma can occur in the bile ducts of hepatolithiasis.
METHODS
We studied 55 cases of hepatolithiasis and examined the specimens of resected liver tissue with a microscope. The growth patterns of bile duct epithelium were divided into four types: flat, tufting, micropapillary and papillary. The dysplasia was also divided into low-grade dysplasia (LGD) and high-grade dysplasia (HGD).
RESULTS
Of 55 cases of hepatolithiasis, 30 cases (54.6%) were of the flat pattern, 13 cases (23.6%) the micropapillary pattern, and 11 cases (20%) the tufting pattern. Epithelial hyperplasia was noted in only 36 cases (65.5%) in the large bile ducts, but dysplastic changes were found in 19 cases. Of 19 cases of dysplasia, LGD was present in 14 cases (25.5% of total 55 cases) an HGD in 5 cases (9% of total 55 cases). The epithelial hyperplasia showed histologic growth of the flat pattern in 29 cases out of 36 cases. But LGD (14 cases) had 6 cases of the tufting pattern and 7 cases of the micropapillary pattern. HGD (5 cases) revealed 4 cases of the micropapillary pattern with one case of the tufting pattern.
CONCLUSION
This study suggests that sequences of hyperplasia, low-grade dysplasia and high-grade dysplasia can play a role in the carcinogenesis of bile duct epithelium in hepatolithiasis with the histologic pattern changing from flat to micropapillary growth.
Expression of Glomerular-Smooth Muscle Actin and Vimentin in Idiopathic Membranous Nephropathy as Prognostic Indicators.
Min Jin Lee, Ok Kyung Kim
Korean J Pathol. 2001;35(1):26-34.
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AbstractAbstract PDF
BACKGROUND
The natural history of idiopathic membranous nephropathy (IMN) is heterogeneous with some patients showing spontaneous remission while others show a progressive course leading to end-stage renal failure. We tried to assess quantitatively alpha-smooth muscle actin (alpha-SMA) and vimentin expression as markers to predict the outcome of membranous nephropathy.
METHODS
This study included 24 patients with biopsy proven IMN. We measured the volume of the positive area for alpha-SMA and vimentin within the glomeruli and compared the results with 5 patients in the normal control group. We evaluated glomerular alpha-SMA and vimentin expression in correlation with BUN and serum creatinine level at the time of diagnosis and after treatment.
RESULTS
Glomerular alpha-SMA and vimentin in IMN were higher than in the control group. Glomerular alpha-SMA was significantly higher in progressive IMN than in non-progressive IMN. The glomerular alpha-SMA was sifnificantly correlated with BUN and serum creatinine at last follow-up (p<0.05), but there was no statistically significant correlation at diagnosis. The glomerular vimentin was not different between progressive and non-progressive groups.
CONCLUSION
These data suggest that the expression of glomerular alpha-SMA may be a useful prognostic indicator and may be able to differentiate between patients with membranous nephropathy who respond well to treatment and those who continue to progress.
Pathologic Characteristics of Korean Prostatic Adenocarcinoma: A Mapping Analysis of 60 Cases.
Yoon La Choi, Sung Rim Kim, Sang Yong Song, Han Yong Choi
Korean J Pathol. 2001;35(1):35-40.
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AbstractAbstract PDF
BACKGROUND
Pathologic characteristics of the prostatic adenocarcinoma in Korean patients are not clear. We studied 60 cases of radical prostatectomy specimens using mapping analysis in an effort to discover the pathologic characteristics of the Korean prostatic adenocarcinoma.
METHODS
A resected prostate was sectioned serially and embedded near-totally. Gleason score, tumor volume or size, capsular extension, involvement of lateral margin, seminal vesicle, vas, apex and base, presence of lymphatic and neural invasion, and presence of high grade prostatic intraepithelial neoplasm (HGPIN) were examined. DNA ploidy and proliferative index were evaluated.
RESULTS
Mean values were as follows: age, 63.6 years; serum prostate specific antigen level (sPSA), 24.0 ng/ml; tumor amount (volume, 29.1%; size, 2.4 cm); Gleason score, 7.3; aneuploidy, 23.3%; proliferative index, 14.2%. Involvement rates of apex, base, seminal vesicle, resection margin, nerve and lymphatics were 5.2%, 39.0%, 23.7%, 31.7%, 56.7% and 16.7%, respectively. Rates of multifocal tumors and HGPIN were 43.3% and 63.3%, respectively. The Gleason score was correlated with tumor amount (volume%, p<0.001; size, p<0.01) and tumor extent (T) (p<0.005). Tumor amount was correlated with sPSA (p<0.05) and T (p<0.005). T was correlated with sPSA (p<0.05).
CONCLUSION
Korean prostatic adenocarcinomas showed higher Gleason scores, lower HGPIN rates and multifocalities in comparison to western prostatic adenocarcinomas, suggestive of the Korean prostatic adenocarcinomas' late detection.
Expressions of MIB-1, p53 and CEA in Endocervical Glandular Lesions.
Mi Jin Kim, Young Gi Lee, Dong Sug Kim
Korean J Pathol. 2001;35(1):41-47.
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AbstractAbstract PDF
BACKGROUND
Endocervical glandular lesions include glandular atypia (GA), endocervical glandular dysplasia (EGD), adenocarcinoma in situ (AIS), and invasive adenocarcinoma (IA). The diagnosis of malignant glandular lesions is occasionally difficult to distinguish from benign mimickers, and the morphologic features of EGD remain unsettled.
METHODS
Immunohistochemical stains for MIB-1, p53 and CEA were performed on 81 cases of paraffin-embedded endocervical glandular lesions including 22 IA, 15 AIS, 15 EGD, 13 GA, 8 microglandular hyperplasia (MGH) and 8 tubal metaplasia (TM).
RESULTS
The MIB-1 labelling index of IA was 59.68%, 69.53% for AIS, 26.60% for EGD, 16.03% for benign. p53 overexpression was noted in 4 (18%) cases of IA, 3 (20%) of AIS, but none of EGD and benign lesions. It was Interesting to note that one case of MGH showed p53 staining in low intensity. Diffuse strong cytoplasmic CEA positivity was present in all of IA and AIS, whereas seven (47%) of 15 EGD and 12 (41%) of 29 benign lesions showed focal cytoplasmic CEA positivity. There were significant differences in MIB-1 and CEA immunostainings among the adenocarcinoma, EGD, and benign glandular lesions. Adenocarcinoma was closely related to p53 overexpression, although occurring in a low percentage of the cases.
CONCLUSION
MIB-1 immunostaining can be useful in differentiating among endocervical adenocarcinoma, endocervical glandular dysplasia and benign glandular lesions. p53 overexpression might be helpful in the diagnosis of adenocarcinoma.
Immunolocalization of the Apoptotic Inhibiting Protein (bcl-2) in Early Normal Pregnancy and Abortion.
Jiae Lee, Jeong Wook Kim, Bum Chae Choi, Kwang Moon Yang, Young Youl Cho, Sung Ran Hong
Korean J Pathol. 2001;35(1):48-52.
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AbstractAbstract PDF
BACKGROUND
The human placenta is an important organ in the maintenance of pregnancy, having functions in maturation and differentiation until the end of pregnancy. The bcl-2 protein is a proto-oncogene that prevents apoptosis and maintains cell survival. However, the mechanism through which bcl-2 inhibits apoptosis is unclear. The aims of this study are to localize bcl-2 at the placenta and to determine whether the expression of bcl-2 in early normal pregnancy is different from that of a missed abortion.
METHODS
Immunohistochemistry was performed for bcl-2 in formalin-fixed chorionic villi and decidual tissue collected from five early normal pregnancies and eleven missed abortions having histories of recurrent abortions during the first trimester.
RESULTS
The bcl-2 protein was observed in the syncytiotrophoblasts of chorionic villi and decidua in both the normal pregnancy and the missed abortion, and the expression of bcl-2 significantly increased in the missed abortion group (p<0.05).
CONCLUSION
The bcl-2 may be necessary to maintain pregnancy through modulating the survival of the syncytiotrophoblast and decidua without affecting cell proliferation, and the increased bcl-2 expression is presumed to be a reparative process to the increased apoptotic activity.
Telomerase mRNA Expression by In Situ Hybridization in Premalignant Lesions and Carcinomas of the Breast.
Young Kyung Bae, Dong Sug Kim, Soo Jung Lee, Koing Bo Kwun
Korean J Pathol. 2001;35(1):53-59.
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AbstractAbstract PDF
BACKGROUND
Telomerase is a ribonucleoprotein, DNA polymerase that synthesizes telomere repeats onto chromosomal ends and maintains telomere length. Telomerase activity has been detected in a broad range of human malignant neoplasms, but not in normal somatic cells. So, activation of telomerase may represent an essential step in the malignant transformation of cells. However, the expression of telomerase in premalignant lesions remains relatively unexplored. This study was conducted to investigate the reactivation of telomerase in the carcinogenesis of human breast tissue.
METHODS
In situ hybridization for the telomerase RNA component (human telomerase mRNA; hTR) was used in a normal breast tissue (n=41), florid ductal hyperplasia (FDH) (n=10), atypical ductal hyperplasia (ADH) (n=3), ductal carcinoma in situ (DCIS) (n=44) and invasive carcinoma (n=33). hTR expression in relation to p53 status and the pathologic parameters in breast cancer was also studied.
RESULTS
Expression of hTR was demonstrated in 13 samples (31.7%) of normal breast tissues, 4 (40%) of FDH, 3 (100%) of ADH, 42 (95.5%) of DCIS, and 33 (100%) of invasive carcinoma. The rate of hTR expression of ADH was significantly different from that of FDH (p<0.05), and there were no differences in hTR expression rates among ADH, DCIS and invasive carcinomas. There was no correlation between hTR expression and nuclear grade, tumor size, and p53 status in invasive carcinomas.
CONCLUSION
These results suggest that telomerase activation may be an early event and an essential step in the carcinogenesis of human breast tissue, and that telomerase has no correlations with p53 status and prognostic parameters.
Expression of c-fos, p53, Transforming Growth Factor-beta1 and Glial Fibrillary Acidic Protein in Hippocampus Following Transient Forebrain Ischemia in Mongolian Gerbil.
Jae Hwa Lee, Bang Hur
Korean J Pathol. 2001;35(1):60-70.
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AbstractAbstract PDF
BACKGROUND
Recent studies have shown that delayed neuronal death is closely associated with early gene (c-fos or c-jun)-related apoptosis in addition to hypoxia-induced energy deficiency in the hippocampus.
METHODS
To elucidate the role of c-fos, p53, TGF-1 and glial fibrillary acidic protein (GFAP) and their interactions, cellular expression with immunohistochemistry was examined during the time period of 10-minute hypoxia with variable reperfusion intervals in the mongolian gerbil hippocampus.
RESULTS
Hippocampal CA1 shows progressive and delayed neuronal damage beginning from the 24-hour reperfusion, while CA2-3 reveals non-progressive, eosinophilic inclusion body within the neuron throughout the time period. CA1 neurons show short-term expressions of c-fos prior to significant cellular damage. However, CA2-3 neurons show persistent expressions by 3-day reperfusion. In both CA1 and CA2-3, p53 is expressed for the short-term period of the early time points. However, its intensity and duration are much less in CA2-3 than in CA1. While TGF-1 is transiently expressed at 24-hour reperfusion in CA1, its expression in CA2-3 is persistent in late time points. Early expression of GFAP is observed in the pyramidal layer of CA1 prior to neuronal damage and progressively increased in the late time points.
CONCLUSION
These results suggest that c-fos and TGF-1 may play a role in neuronal viability in the early- and late time points. Astrocytes may also be responsible for the active protective mechanism to neuronal death, as well as reactive gliosis. The hypoxia-induced neuronal damage is, in part, a p53-dependent process in the CA1 neurons.
Case Reports
Cardiac Sarcoidosis Treated by Cardiac Transplantation: A Case Report.
Jaejung Jang, Kwangseon Min, Gyeong cheon Jung, Jaejung Kim, Inchul Lee
Korean J Pathol. 2001;35(1):71-75.
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AbstractAbstract PDF
Sarcoidosis, in general, has a low mortality rate. But cardiac sarcoidosis (CS) is a serious condition which may lead to death. Here, we report a rare case of CS that was treated by heart transplantation. A 47-year-old male had occasional syncopes and atypical chest pain. Ventricular tachycardia with right bundle branch block was noted by electrocardiogram. Multiple fixed myocardial perfusion defects in the interventricular septum and both the inferior-posterior ventricular walls were observed by thallium scan. Coronary angiography was unremarkable. Neither perihilar nor mediastinal lymphadenopathy was noted. The patient also suffered three times from tonic-clonic generalized seizures in 3 years, but no neurologic abnormalities were detected. The explanted heart displayed multiple white patches on the endomyocardial surface, measuring up to 8x7 cm. On microscopic examination, the lesion consisted of multiple well-formed and confluent granulomas with numerous scattered multinucleated giant cells, CD68-positive epithelioid histiocytes, and T-lymphocytes. Neither microorganisms nor foreign material was identified on special stain and culture study. It has been six months since the heart transplant, and the patient has been doing well.
Gastric Collision Tumor (Adenocarcinoma and Neuro-endocrine Carcinoma): A Report of Two Cases.
Ho Sung Park, Ja Myoung Chung, Woo Sung Moon, Myoung Jae Kang, Dong Geun Lee
Korean J Pathol. 2001;35(1):76-79.
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AbstractAbstract PDF
Concurrence of adenocarcinoma and neuroendocrine carcinoma in the gastrointestinal tract has rarely been observed. We report two cases of gastric collision tumors (adenocarcinoma and neuroendocrine carcinoma) that developed in a 64-year-old man and a 71-year-old man. In both cases, there was a single ulcerative lesion in the stomach. Histologically, the gastric lesions were composed of two discrete lesions: tubular adenocarcinoma at the edge of an ulcer and neuroendocrine carcinoma in the ulcer base. We will discuss collision and composite tumors.
Primary Extramedullary Plasmacytoma of the Colon: A Case Report.
Ok Ran Shin, Gyeong Shin Park, Youn Soo Lee, Eun Sun Jung, Sun Moo Kim, Byung Kee Kim
Korean J Pathol. 2001;35(1):80-82.
  • 1,337 View
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AbstractAbstract PDF
Extramedullary plasmacytoma is a relatively rare tumor, occuring in a wide variety of organs and tissues, and is most frequently seen in the oral cavity and upper respiratory tract. Solitary extramedullary plasmacytoma located in the gastrointestinal tract is rare, especially the in colon. We report a case of solitary extramedullary plasmacytoma in the cecum of a 58-year-old man which simulated a carcinoma both endoscopically and radiologically. But histopathologic evaluation demonstrated a sheet-like proliferation of pure plasma cells with monoclonality for IgM and lamda chain which confirmed the diagnosis of plasmacytoma.
Mature Teratoma of the Rectum: A Case Report.
Kyung Sun Park, Mi Seon Kang, Young Ju Kim, Chan Hwan Kim, Hye Kyoung Yoon
Korean J Pathol. 2001;35(1):83-85.
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AbstractAbstract PDF
Teratoma commonly affects the gonads. Its occurrence in extragonadal sites has also been reported. However, teratoma affecting the gastrointestinal tract is extremely uncommon. Herein, we describe a rare case of rectal teratoma presenting a solid polypoid tumor. A 61-year-old woman with constipation is presented. She had a colonoscopic examination and was noted to have a pedunculated polyp at the rectum, located 15 cm from the anal verge. The 4.2x2.4x2.0 cm polyp arose at the rectal mucosa which had a long stalk and smooth surface. The cut surface showed a solid area with a central yellow area. Microscopically, the polyp was covered with keratinizing stratified squamous epithelium which was abruptly exchanged from the columnar rectal mucosa. Sebaceous glands, sweat glands and hair follicles were mixed in stroma under the surface of the polyp. The central portion of the polyp was composed of mature adipose tissue and collagen fibers. Mature neural elements were noted in the stalk.
Primary Carcinoid Tumor Arising in a Mature Teratoma of the Testis: A Case Report.
Jai Hyang Go
Korean J Pathol. 2001;35(1):86-88.
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AbstractAbstract PDF
Primary carcinoid tumor is rarely associated with mature teratoma in the testis. In the few cases reported, the primary carcinoid tumors in the testis were often microscopic in size. Although it has been generally accepted that carcinoids arising in teratomas have an indolent clinical course, some of these tumors have been reported to metastasize and cause death of the patient. Therefore, long term follow up may be warranted for patients having primary testicular carcinoid tumors irrespective of coexisting teratoma. We report a case of primary testicular carcinoid tumor of microscopic size incidentally found in mature cystic teratoma occurring in a 44 year-old male patient.

JPTM : Journal of Pathology and Translational Medicine