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Volume 37(4); August 2003
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Original Articles
An Analysis for Angiotensin Converting Enzyme Gene Polymorphism in Formalin-fixed, Paraffin-embedded Tissues from Patients with Sarcoidosis.
Tae Sook Kim, Hee Yeon Hong, In chul Lee
Korean J Pathol. 2003;37(4):225-231.
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AbstractAbstract PDF
BACKGROUND
Sarcoidosis is a systemic disease characterized by nonnecrotizing granulomas involving the lung and hilar lymph nodes. Serum angiotensin converting enzyme (sACE) levelsin patients with sarcoidosis have been implicated as an indicator of granuloma burden.Recently, it has been found that ACE gene insertion/deletion (ID) polymorphism affects sACE levels in healthy individuals. Moreover, reported sACE levels were highest in the deletion/deletion(DD) genotype. Previous studies to investigate the distribution of ACE genotypes accordingto ethnic groups have revealed various results and have caused controversy.
METHODS
Polymerase chain reactions were performed to determine the ACE genotypes in fifteen formalinfixed, paraffin-embedded tissues from patients with sarcoidosis.
RESULTS
The distribution of ACE gene (I/D) polymorphism in patients with sarcoidosis was significantly different from that in normal controls. The DD genotype was more frequent in patients with sarcoidosis than in thenormal controls. The D allele frequency was also higher in patients with sarcoidosis than in thenormal controls. The relative risk of sarcoidosis was higher in DD homozygotes.
CONCLUSIONS
These results suggested the ACE gene I/D polymorphism may play an important rolein the pathogenesis and progression of sarcoidosis.
Analysis of Gene Expression in Renal Cell Carcinomas Using cDNA Microarray: Reduced Expression of Decorin in Renal Cell Carcinomas.
Jin Sook Lee, Kang Suek Suh, Kyung Un Choi, Jee Yeun Kim, Do Youn Park
Korean J Pathol. 2003;37(4):232-238.
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AbstractAbstract PDF
BACKGROUND
Identification of the genes expressed differentially in renal cell carcinoma (RCC)but not in the non-cancerous kidney is important for understanding the molecular basis ofrenal cell carcinoma and for defining possible prognostic value and therapeutic intervention.We investigated the changes in gene expression accompanying the development and progression of kidney cancer by cDNA microarrays.
METHODS
To identify molecular alterations in renal cell carcinoma, we measured expression profiles for paired neoplastic and noncancerouskidney samples from an individual by means of a cDNA microarry representing 7, 500genes. Of the differentially expressed genes, we assessed the decorin gene at the proteinlevel using immunohistochemistry.
RESULTS
The 60 genes were noted to have more than a fivefold change in expression (either increased or decreased) in RCC compared to the noncancerouskidney. The changed genes are those associated with signal transduction, metabolizingenzymes, the cytoskeleton, cell adhesion, cell cycle control, modulation of transcription, the tumor suppressor gene and tumor antigens. Under immunohistochemistry, the expressionof decorin was significantly decreased in the tumor than in the non-cancerous kidney.The expression rate of decorin was not associated with the patient's sex, age, histologic type, Fuhrmann nuclear grade and T stage.
CONCLUSION
The author predicted that these geneexpression profiling experiments will lead to improvements in the basic understanding of renaltumor pathogenesis and will promote the discovery of novel molecular markers for renal tumordiagnosis and therapy.
KAI-1 Protein Expression in Breast Cancer: Correlation with Axillary Lymph Node Metastasis and other Prognostic Factors.
Shi Nae Lee, Min Sun Cho, Sun Hee Sung, Hea soo Koo, Ok Kyung Kim, Woon Sup Han
Korean J Pathol. 2003;37(4):239-245.
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AbstractAbstract PDF
BACKGROUND
KAI-1 is a metastasis suppressor gene. We have evaluated the correlationbetween KAI-1 protein expression in ductal carcinomas of the breast and axillary lymph nodemetastasis.
METHODS
The expression of KAI-1 protein was confirmed by immunohistochemistryto examine breast tissues of ductal carcinomas from 50 patients with nodal metastasisand from 53 patients without metastasis. Western blot analysis was performed on fresh frozenbreast tissues from 17 cases with nodal metastasis and from 19 cases without metastasis.
RESULTS
Immunohistochemical KAI-1 protein expression was decreased or negative in 39out of 50 cases with metastasis (78%), compared with 8 out of 53 cases with no metastasis(15.1%). The difference was statistically significant (p<0.05). Immunohistochemical KAI-1protein expression was significantly decreased in cases with higher modified Black's nucleargrade (p=0.027) and larger tumor size (p=0.039). Western blot analysis showed positivebands at 29.5 kDa in 8 out of 19 cases without metastasis (42.1%), and none of the 17 caseswith metastasis showed positive bands (p=0.0024).
CONCLUSION
These results suggest thepossibility that KAl-1 might play a major role of a metastasis suppressor gene in addition tothe part it plays in the growth and progression of human breast ductal carcinoma. In addition, the decreased expression of KAI-1 protein in breast ductal carcinomas could be used as afactor suggesting poor prognosis.
c-kitMutation and Immunohistochemical Expression in Gastrointestinal Stromal Tumors.
Dong Wook Kang, Joo Heon Kim, Dong Hun Kim, Kung Hee Kim, Mee Ja Park, Dae Young Kang
Korean J Pathol. 2003;37(4):246-254.
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AbstractAbstract PDF
BACKGROUND
Gastrointestinal stromal tumor (GIST) is the most common non-epithelial neoplasm arising in the gastrointestinal tract. The aim of this study is to investigate the correlation among the clinicopathologic features, presence of c-kit mutation, and immunohistochemical expression of c-kit in 61 cases of GISTs.
METHODS
We divided the GISTs into three groups as benign, boderline and malignant, according to histologic grade. Exon 11 of the c-kit was amplified by PCR and sequenced. We performed immunohistochemical study for CD117, CD34, vimentin, SMA, desmin, and S-100 protein.
RESULTS
Twenty-one cases were diagnosed as benign GISTs, 14 cases as borderline GISTs, and 26 cases as malignant GISTs. The shape, atypia, cellularity, and necrosis showed good correlations with the histologic grades of the GISTs.Mutations of exon 11 of the c-kit were detected in 3 benign GISTs, 4 borderline GISTs, and 13(%) malignant GISTs. Sequence analysis confirmed the deletion mutation (n=16) and the singlebase pair mutation (n=4). The immunohistochemical stainings showed myogenic differentiation(n=20), neurogenic differentiation (n=15), and neither myogenic or neurogenic differentiation(n=34).
CONCLUSIONS
The GIST is the primitive mesenchymal tumor capable of divergent differentiation, and the mutation of the c-kit is a good parameter for the malignant GIST.
Expression of Cyclins (D1, A, E, and B1) in N-butyl-N-(4-hydroxybutyl)nitrosamine-induced Rat Bladder Carcinogenesis.
Gui Young Kwon, Eon Sub Park, Sung Geun Bong, Tae Jin Lee, Mi Kyung Kim, Jae Hyung Yoo, Kye Yong Song
Korean J Pathol. 2003;37(4):255-262.
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AbstractAbstract PDF
BACKGROUND
Cell cycle deregulation plays a major role in chemical multistage carcinogenesis.Therefore, the evaluation of cell cycle proteins is important.
METHODS
In order to induce carcinogenesis in the rat urinary bladder, 0.05% N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN)was administered to male Sprague-Dawley rats for 30 weeks. Expressions of cyclin D1, A, E, and B1 were examined by immunohistochemical stainings.
RESULTS
Urothelial cell hyperplasia appeared at 5 weeks, followed by papilloma at 10 weeks. Superficial carcinoma was observed at 20 weeks, and invasive carcinoma developed in 40% (4/10) of the rats at 30 weeks. Expressions of cyclin D1 and A increased sequentially from normal mucosa throughhyperplasia, papilloma, and carcinoma (p<0.01). Expressions of cyclin D1, B1 and cyclin Ewere higher in invasive carcinomas than in superficial carcinomas (p<0.01). In contrast, therewas no significant difference in the expression of cyclin B1 between hyperplasia, papillomaand superficial carcinoma.
CONCLUSIONS
The present results indicate the important roles of cyclin D1 and A in the development of BBN-induced urothelial carcinoma of rats. Aberrantexpression of cyclin B1 and E may contribute to the progression from superficial to invasivebladder cancer rather than tumorigenesis.
Significance of CD99 Immunoreactive Cells in relation to Gastrin-producing Cells in Human Gastric Mucosa.
Eun Young Kim, Jong Im Lee, Jung Ran Kim
Korean J Pathol. 2003;37(4):263-269.
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AbstractAbstract PDF
BACKGROUND
CD99 is characteristically expressed in Ewing's sarcoma/primitive neuroendocrine tumors and its immunoreactivity has also been reported in gastrointestinal neuroendocrine tumors. However, the normal distribution of CD99 reactive cells in gastrointestinal mucosa and their function are not fully understood.
METHODS
We performed an immunohistochemical study using antibodies to CD99 and gastrin on formalin fixed and paraffin embedded tissue of the stomach.
RESULTS
CD99 were strongly expressed in the gastric glands of neonate (3/3) and infant (1/1) cases but not detected in the fetal period (0/30). In adults, CD99 was observed in 36.8% (7/19). The number of CD99 positive cells were fewer in adult (3.48+/-6.43) than in neonate (5.66+/-0.58) and infant (11.33+/-2.21). CD99 was mostly located along the cytoplasmic membrane of glandular cells but cytoplasmic expression was also evident in neonate and infant cases. The G cells and CD99 expressed cells were reduced in the area showing intestinal metaplasia and atrophic change. As a result of the double stain, some of the G cells coexpress CD99 antigen, which were more in neonate (29%) than in adult (2.6%).
CONCLUSIONS
The CD99 positive cells were found in the gastric pyloric antrum during the postnatal period and progressively reduced with age. This suggests the participation of CD99 protein in the differentiation and secretory process of neuroendocrine cells.
Prevalence and Clinicopathologic Features of Mucinous Cystic Tumor and Intraductal Papillary Mucinous Tumor of Pancreas in Korea.
Jin Hee Sohn, Kyung Me Kim, Seoung Wan Chae, Woo Ho Kim, Woo Sung Moon, Young Nyun Park, Chul Gun Park, Eun sil Yu, Hee Kyung Jang, Hee Jin Jang, Jong Jae Jung, Jin Sook Jung, So Young Jin, Jong Sang Choi, Dae Young Kang
Korean J Pathol. 2003;37(4):270-278.
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AbstractAbstract PDF
BACKGROUND
Mucin producing cystic neoplasms, such as mucinous cystic tumor (MCT) and intraductal papillary mucinous tumor (IPMT) of the pancreas, are uncommon but become increasing in their incidences. The pathologic classification and biologic potential of these neoplasmsremain the subject of controversy.
METHODS
The Gastrointestinal Pathology Study Group of the Korean Society of Pathologists analyzed the clinicopathologic characteristics of 85 casesof MCT and 72 cases of IPMT and examined the expression patterns of p53, CEA and MUC1.
RESULTS
IPMT was located largely in the head, and showed connection with the main pancreatic duct (MPD, 68.1%), no ovarian-like stroma (0/72), and presence of intervening intratumoralnormal or atrophic parenchyma. On the other hand, MCT was located largely in thetail (73%), and showed common ovarian-like stroma (66/80), rare connection with the MPD(7/85) and no intervening pancreatic parenchyma. CEA and p53 immunoexpressions weresignificantly increased from adenoma through borderline to carcinoma, but MUC 1 was expressedonly in the invasive carcinoma among cases of MCT and IPMT.
CONCLUSIONS
The tumorlocation, ovarian-like stroma, connection with the MPD and intratumoral intervening nonneoplastictissue were helpful in the differential diagnosis between IPMT and MCT. CEA and p53expressions can be indicators of malignancy, while MUC 1 expression can indicate invasion.
Case Reports
Rounded Atelectasis: A Brief Case Report.
Gou Young Kim, Ji Young Park, Joung ho Han, Tae Seong Kim, Jhin gook Kim
Korean J Pathol. 2003;37(4):279-281.
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AbstractAbstract PDF
Rounded atelectasis is a focal, pleural-based lesion that is the result of pleural and subpleural scarring and atelectasis of the adjacent lung tissue. We experienced a case of asbestosassociated rounded atelectasis that had developed in a 50-year-old male. When examined with routine chest radiography, the patient was shown to have an asymptomatic chest mass.Computed tomography showed a pleural-based mass with a curvilinear shape about 4.2 cmin greatest diameter in the medial basal segment of the right lower lobe. To exclude the possibilityof malignancy the mass was excised by video-assisted thoracotomy. The mass wasround and firm, and was gray and yellow in color. Microscopically, marked pleural fibrosisextended into the underlying lung parenchyme and then resulted in atelectasis. There areferruginous bodies in dense fibrous pleura.
High-grade Transformation of Primary Nodal Marginal Zone B-Cell Lymphoma: A Case Report.
Joo Heon Kim, Dong Wook Kang, Mee Ja Park, Jin Man Kim
Korean J Pathol. 2003;37(4):282-286.
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AbstractAbstract PDF
Primary nodal marginal zone B-cell lymphoma (MZBCL) is recognized as a rare and distinct entity. The rate of histologic transformation into diffuse large B-cell lymphoma (DLBCL) seems lower than the rate of transformation in follicular lymphoma. We herein report a rare case ofnodal MZBCL showing transformation into DLBCL. The patient was a 73-year-old female withcervical lymphadenopathy. On the initial biopsy, the lymph node architecture was diffuselyeffaced with an extensive interfollicular and parafollicular infiltrate of monocytoid B-cells. Therewere scattered large blastic B-cells without formations of compact sheets. The diagnosis ofnodal MZBCL was made. The patient did not receive chemotherapy and was treated with aconservatively supportive regimen. Forty two months later, the patient developed a new cervicallymphadenopathy and a biopsy was performed. Histologically, the lymph node revealeddiffuse sheets of transformed large B-cells showing prominent nucleoli. The diagnosis ofDLBCL transformed from nodal MZBCL was made. The patient was treated with 3 cycles ofcombined CHOP chemotherapy and she showed clinical improvement. These observationssuggest that an untreated primary nodal MZBCL may undergo high-grade transformation.
Scleroma of the Larynx: A Case Report.
Hun Soo Kim, Seok Won Park, Jin Man Kim
Korean J Pathol. 2003;37(4):287-290.
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AbstractAbstract PDF
Scleroma of the larynx is a rare specific granulomatous disease and is usually presented as alaryngeal extension of a primary rhinoscleroma. We report an unusual case of laryngeal scleromain a 64-year-old female patient whose presented with progressive upper respiratory obstructivesymptoms lasted for 2 years. Symptoms were acutely exaggerated during the course of one month.On physical examination, the nasal mucosa was atrophic and crusted, and septal perforationwas noted. The fiberoptic laryngoscopy revealed a yellowish granulated epiglottic mass with adirty surface mimicking laryngeal cancer. Histological sectioning showed the characteristic featuresof scleroma including Mikulicz cells with scattered plasma cells and some neutrophils.Warthin-starry stains and electron microscopy examination showed numerous short rods insidethe cytoplasm of the Mikulicz cells. After the diagnosis, the patient underwent an emergency tracheostomyfollowed by long-term antibiotic treatment, and her symptoms have slowly improved.
Inflammatory Myofibroblastic Tumor (InflammatoryFibrosarcoma) of the Lung: A Case Report.
Minseob Eom, Tae Heon Kim, Jin Kyu Park, Kwang Hwa Park, Soon Hee Jung, Kwang Gil Lee
Korean J Pathol. 2003;37(4):291-295.
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AbstractAbstract PDF
Inflammatory myofibroblastic tumor, also known as inflammatory fibrosarcoma, has been frequently diagnosed as inflammatory pseudotumor. Although there are six cases reported as inflammatory pseudotumors or inflammatory myofibroblastic tumors in the lung, no cases of pulmonary inflammatory myofibroblastic tumor with features of inflammatory fibrosarcoma have been reported in Korea. We experienced a case of inflammatory myofibroblastic tumor (inflammatory fibrosarcoma)characterized by high cellularity, severe nuclear pleomorphism, necrosis, or increased mitoticcounts. A 31-year-old male patient with a solitary pulmonary nodule on the routine chest x-rayreceived a right lower lobectomy. The tumor was an ovoid solid mass with multifocal necrosis, showing diffuse irregular proliferation of spindle cells with high cellularity and focal nuclear pleomorphism, admixed with dense lymphoplasmacytic cells. Although spindle cells are focally immunoreactivefor smooth muscle actin, the ultrastructural examination failed to demonstrate smooth muscledifferentiation. In cases of inflammatory myofibroblastic tumor (inflammatory fibrosarcoma), a completeexcision and close follow-up without radical surgery, radiation, or chemotherapy are needed.
Mediastinal Parathyroid Cyst.
Dong Hoon Kim, Gou Young Kim, Joung ho Han, Tae Seong Kim, Jhin gook Kim
Korean J Pathol. 2003;37(4):296-297.
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AbstractAbstract PDF
The mediastinal parathyroid cyst is a very rare cause of space occupying lesions in the mediastinum.We report a case of a non-functioning mediastinal parathyroid cyst that occurred ina 42 year-old male. He suffered from foreign body sensation of the throat whenever he wasin the supine position. A chest computed tomography showed a round cyst with a narrowbase attached to trachea. It was white and tan, thin-walled semi-transparent cyst containingyellow and tan serous fluid. Microscopically it was characterized by a thin fibrous wall linedwith a single or double layer of uniform cells with clear cytoplasm and small nuclei. The liningcells were immunopositive for chromogranin A.
Eccrine Syringofibroadenoma: A Case Report.
Hee Jeong Lee, Jinyoung Yoo, Seok Jin Kang, Byung Kee Kim, Chang Suk Kang
Korean J Pathol. 2003;37(4):298-299.
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AbstractAbstract PDF
Eccrine syringofibroadenoma is an uncommon benign eccrine tumor, which was first described by Mascaro in 1963. It usually develops on the extremeties of elderly persons. Recently we experienceda case of eccrine syringofibroadenoma that occured in a 38-year-old woman. She presentedus an asymptomatic solitary reddish nodular plaque with a verrucous surface, whichshe'd had on her right arm for three months. Histologically, slender anastomosing epithelial cellcords with focal luminal differentiation resembling duct structures were embedded in a fibrovascularstroma. The net-like pattern of epithelial cells resembled that seen in fibroepithelioma.

JPTM : Journal of Pathology and Translational Medicine