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Volume 38(5); October 2004
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Original Articles
The Clinicopathologic Analysis of Kikuchi's Lymphadenitis.
Jung Woo Choi, Ji Hye Lee, Ju Han Lee, Yang Seok Chae, Insun Kim
Korean J Pathol. 2004;38(5):289-294.
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AbstractAbstract PDF
BACKGROUND
Kikuchi's disease has been known as a self-limiting lymphadenitis mostly affecting the cervical lymph nodes of young women.
METHODS
We retrospectively reviewed the clinical data of 77 cases of Kikuchi's lymphadenitis from 1996 to 2003 at Korea University Medical Center.
RESULTS
Histologically, 69 available cases were classified into three types: proliferative (60.8%), necrotizing (33.3%), and xanthomatous type (5.7%). These three types differed in terms of their clinical features, showing tenderness most predominantly in the necrotizing type. In spite of the insufficient numbers of cases, the data on the duration of the disease well correlated with the possible progression of the three histologic types (Kikuch's disease begins as proliferative type, then progress into necrotizing type and finally resolves into xanthomatous type). During the ten-month period of the mean follow-up, the recurrence rate was 7.0%. Three and two patients developed into pulmonary tuberculosis and systemic lupus erythematosus, respectively, but there were no prognostic differences among the three types.
CONCLUSIONS
Our results confirmed that Kikuchi's lymphadenitis is a self-limiting necrotizing lymphadenitis with a low rate of recurrence. Here, we suggest that the classification of histologic types have some meanings because of their differences in certain clinical aspects and possible sequential disease progression.
Human Papillomavirus Type 16, 18, and 33 Infection in Adenocarcinoma of the Uterine Cervix: Analysis of the p53 Gene Mutation and the Clincopathologic Correlation.
Kwang Sun Suh, Seong Jun Cho, Sun Young Na, Heung Tae Noh, Sang Ryun Nam
Korean J Pathol. 2004;38(5):295-300.
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AbstractAbstract PDF
BACKGROUND
Current evidence implicates specific types of the human papillomavirus (HPV) are involved in the development of cervical cancer. In HPV-negative cervical carcinomas, p53 mutation is thought to be a mechanism of oncogenesis. The purpose of this study was to evaluate the prevalence of p53 mutations in cervical adenocarcinomas and to investigate their correlation with HPV status and clinicopathologic parameters.
METHODS
A series of 38 primary cervical adenocarcinomas was analyzed for both HPV infection and p53 mutations. The HPV 16, 18, and 33 status was investigated by PCR amplification. The point mutations of the p53 gene were detected by the PCR-SSCP technique.
RESULTS
The prevalence of HPV 16, 18, or 33 infection was 73.7% (28/38). HPV 16 was present in 12 cases, HPV 18 was present in 15 cases, and HPV 33 was positive in one case. There was only one case that was positive for 18 as well as a p53 mutation in exon 6.
CONCLUSIONS
Our results indicate that HPV 18 infection was more common in cervical adenocarcinomas than HPV 16 infection. Mutant p53 was rarely found in cervical adenocarcinomas regardless of the type of HPV infection. There was no correlation between HPV infection and clinical stage or pathologic type of tumor.
Expression Pattern of Smad Proteins in Diffuse Large B-cell Lymphomas.
Jai Hyang Go
Korean J Pathol. 2004;38(5):301-305.
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AbstractAbstract PDF
BACKGROUND
Smad proteins mediate the cellular signaling from members of transforming growth factor-beta family (TGF-beta s). Smads 2 and 3 transmit signals from TGF-beta and activin, and Smads 1, 5, and 8 transmit signals from the bone morphogenetic protein. Smad4 is known to be a common mediator of both pathways, yet little is known about the expression pattern of Smad proteins in normal lymphoid tissue and malignant lymphoma.
METHODS
Immunohistochemistry was performed for Smad3 and Smad4 on the paraffin-embedded tissue sections from 32 cases of diffuse large B-cell lymphomas.
RESULTS
In reactive lymphoid tissue, nearly all cells of the germinal centers were positive for Smad3 and more than 50% of paracortical cells were positive for Smad3. For Smad4 immunostaining, nearly all cells of the germinal centers showed diffuse cytoplasmic staining, and most of them revealed nuclear positivity as well. Most of the cells in the paracortex regions were positive for Smad4. For the malignant lymphomas, all the cases were positive for Smad3, but 26 cases were positive for Smad4 and 6 cases (19%) were negative for Smad4.
CONCLUSIONS
These results suggest that TGF-beta-specific Smads may be actively involved for signal transduction in lymphoid organs, and the TGF-beta signaling pathway through Smads is operative in malignant lymphoma. The loss of Smad4 expression might be associated with development of some diffuse large B-cell lymphomas.
Comparative Analysis of Serum Mannose-Binding Lectin in Normal Population and Patients with Different Types of Cancer.
Bum Joon Kim, Young Sik Kim, Eun Mee Han, Eung Seok Lee, Nam Hee Won, Geung Hwan Ahn, Dale Lee, Bom Woo Yeom
Korean J Pathol. 2004;38(5):306-310.
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AbstractAbstract PDF
BACKGROUND
Mannose-binding lectin (MBL) is a serum protein of innate immunity. Its genetic mutations lead to deficiency of serum MBL and recurrent pyogenic infection in childhood. However, little is known about the frequency of its gene mutations or serum levels in Korean population and patients with cancers.
METHODS
We studied the mutational genotypes of MBL exon 1 codon 52, 54, and 57 or serum MBL levels from 102 normal adults and 228 cases of breast, stomach, colon, uterine cervical, and lung cancers by allele-specific PCR and enzyme-linked immunosorbent assay.
RESULTS
MBL gene mutations were found in 32 of 102 normal adults (31.4%), and were restricted only to exon 1 codon 54 showing homozygous (n=5, 4.9%) or heterozygous mutations (n=27, 26.5%). Mean and median serum MBL in the patients with cancers were increased (2,647+/-1,742 and 2,915 ng/mL, mean+/-S.D. and median) than those of normal adults (1,906+/-1,359 and 1,758 ng/mL). Serum MBL level was significantly increased in the patients with stomach, uterine cervical, colon, and lung cancers.
CONCLUSION
Our results indicate that the frequency and pattern of MBL gene mutations and its serum level is very similar among northeastern Asian populations. In addition, MBL might be involved in an immunologic response against common cancers, although further studies are needed.
Minocycline Attenuates the Development of Allodynia: An Immunohistochemical Study on CD11b, GFAP and c-Fos in the Spinal Dorsal Horn in SD Rat.
Gu Kang, Ki Young Choi, Min Sup Lee, Young Jun Ahn, Seong Sik Kang, Il Young Cheong, Wanjoo Chun, Sung Soo Kim
Korean J Pathol. 2004;38(5):311-318.
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AbstractAbstract PDF
BACKGROUND
Minocycline, a semisynthetic second-generation tetracycline, is an antibiotic that has excellent ability to penetration into the CNS via the brain-blood barrier. Minocycline has emerged as a potent inhibitor of microglial activation, and it is an effective neuroprotective agent in experimental brain ischemia. Glial cell activation and proliferation are known to be associated with neuropathic pain in the peripheral nerve injuries.
METHODS
The fifty percent threshold of withdrawal responses was measured in the hindpaws of SD rats following tight ligation of left fifth lumbar spinal nerve. Rats were sacrificed at 1, 3, 5, and 7 days and at 0.5, 1, 2, and 4 h post ligation (n=5/group/time point). Immunohistochemistry for GFAP, CD11b and c-Fos was done on the spinal cord at the level of the fifth lumbar nerve. Minocycline (45 mg/kg) and normal saline (300-400 microL) were administered intraperitoneally, 1 day and 1 h before the operations, and every day postoperatively until the rats were sacrificed.
RESULTS
Treatment with minocycline reduced allodynia and the expressions of CD11b at 5 days and c-Fos at 1 and 2 h post operation compared with the saline treatment (control). CONCLUSIONS: It was thought that minocycline reduced the allodynia induced by tight ligation of the fifth lumbar spinal nerve in rats through the inhibition of microglial activation and c-Fos expression.
Expression of Anaphase Promoting Complex (APC) and APC Regulatory Proteins in Invasive Ductal Carcinoma Associated with Paget's Disease.
Kwang Hwa Park, Sang Yeop Yi, Woo Ick Yang, Yup Kang, Kwang Gil Lee
Korean J Pathol. 2004;38(5):319-323.
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AbstractAbstract PDF
BACKGROUND
Oncogene expression in Paget's disease of the breast is not well known. To characterize invasive ductal carcinoma associated with Paget's disease, we studied expression of anaphase promoting complex (APC) with its regulatory proteins.
METHODS
Immunohistochemical stainings were done with 10 cases of invasive ductal carcinoma associated with Paget's disease for APC, pituitary tumor transforming gene (PTTG), cyclin B1, p53, cyclin D1, and c-erbB-2. The expressions of these markers in Paget's disease were compared with those in the associated with carcinoma.
RESULTS
APC, PTTG, cyclin B1, and c-erbB-2 were positive in all of the cases with both Paget's disease and underlying carcinoma. p53 was expressed in Paget's disease of 6 cases (60%) and in carcinoma of 7 cases (70%). Cyclin D1 was positive in Paget's disease of 8 cases (80%) and in carcinoma of 9 cases (90%).
CONCLUSIONS
Breast carcinomas with Paget's disease seem to be distinguished by the high expression of APC, cyclin B1, PTTG, c-erbB2, and cyclin D1 in contrast to breast cancers without Paget's disease. Furthermore, the similar expression patterns of APC and APC regulatory proteins in both Paget's disease and underlying breast cancer support the epidermotropic theory as its pathogenetic mechanism.
Expression of pS2/TFF1 Protein in Normal Colonic Mucosa, Adenoma and Adenocarcinoma.
Seoung Wan Chae, Eun Yoon Cho, Eo Jin Kim, Jin Hee Sohn, Young Euy Park
Korean J Pathol. 2004;38(5):324-329.
  • 1,387 View
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AbstractAbstract PDF
BACKGROUND
The trefoil factor 1 protein (pS2/TFF1) is a candidate tumor-suppressor protein, and it is a pleiotropic factor involved in the organization and homeostasis of the gastrointestinal tract and various inflammatory or neoplastic diseases. The purpose of this study was to assess the expression of pS2/TFF1 and its clinicopathologic relationship, including the p53 and Ki-67 labeling index, in colorectal carcinogenesis.
METHODS
The expression of pS2/TFF1 protein was evaluated immunohistochemically in 45 samples of normal colonic mucosa, 43 samples of adenoma and 186 samples of colorectal carcinoma.
RESULTS
pS2/TFF1 protein was expressed weakly in 37.8% of normal colonic mucosa samples, and it had a weak to strong expression in 48.8% of adenomas and 28% of colorectal adenocarcinomas. pS2/TFF1 expression in carcinoma was slightly increased in the poorly differentiated group compared with the well to moderately differentiated group (p=0.059). Interestingly, mucinous carcinoma (4/4) and signet ring cell carcinoma (2/3) showed significant increase of pS2/TFF1 expression. pS2/TFF1 expression was inversely correlated with the p53 protein expression and the Ki-67 labelling index (p<0.05). There was no significant correlation with the tumor size, metastasis or pathologic staging.
CONCLUSIONS
Overexpression of pS2/TFF1 expression in colorectal adenocarcinoma was inversely correlated with the Ki-67 labelling index and the p53 expression in cancer. These results suggest that pS2/TFF1 protein may contribute as tumor suppressor factor in colorectal adenocarcinoma.
Case Reports
Toxoplasmic Lymphadenitis with Toxoplasma Bradyzoites: A Case Report.
Hwa Eun Oh, Insun Kim
Korean J Pathol. 2004;38(5):330-332.
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AbstractAbstract PDF
Toxoplasmic lymphadenitis is the most frequently observed clinical form of acquired toxoplasmosis. It is diagnosed by observing the characteristic histopathology, performing serologic tests and demonstrating the organisms. However, detection of the organisms in lymph node section is rarely accomplished. We demonstrate a case of a toxoplasmic lymphadenitis of a 40-year-old man with bradyzoites. The histopathologic findings of the lymph nodes showed reactive follicular hyperplasia associated with the presence of irregular clusters of epithelioid histiocytes, usually located in the cortical and paracortical zones, and monocytoid B cell proliferation. We demonstrated the bradyzoites of Toxoplasma gondii with periodic acid-Schiff (PAS)-stain, and serologic testing showed positive Ig-G and Ig-M toxoplasma antibodies.
Cutaneous Bronchogenic Cyst Over the Sternum: A Case Report.
Ho Sung Park, Hyun Jin Son, Myoung Jae Kang
Korean J Pathol. 2004;38(5):333-336.
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AbstractAbstract PDF
Bronchogenic cyst is usually an extrapulmonary cyst formed as the result of an accessory lung bud from the foregut that becomes isolated from the rest of the tracheobronchial tree producing a usually solitary cyst. Most bronchogenic cysts are in the mediastinum with rare occurrence on the subcutaneous tissue over the sternum. We report a case of cutaneous bronchogenic cyst that occurred in the skin over the sternum in a 13-month-old boy. On ultrasonography, a well circumscribed non-echogenic cystic mass was observed measuring 1.5x1.3 cm. Histologically, the cyst was lined by cilicated, pseudostratified, columnar epithelium with interspersed goblet cells, and there were bundles of smooth muscle fibers, mucous glands, and lymphoid aggregates in the cyst wall.
An Unusual Type of Acute Renal Failure due to Extensive Crystal Deposition in the Renal Tubular Epithelium and Interstitium: A Case Report.
Ja Seung Koo, Eunah Shin, Shin Woo Kang, Hyeon Joo Jeong
Korean J Pathol. 2004;38(5):337-340.
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AbstractAbstract PDF
Acute tubular necrosis is a major cause of acute renal failure. Acute renal failure that is caused by crystal deposition can result from drug toxicity, lymphoplasmacytic neoplasms, ingestion of industrial organic solvents, or intratubular obstruction due to degenerated red blood cells and red blood cell casts. We herein present an uncommon case of acute renal failure in a 57-year-old woman showing an unusually massive accumulation of variable-sized, round, ellipsoid or rhomboid, pale-pink, refractile bodies in the proximal and distal tubular epithelial cells, interstitial macrophages and Bowman's spaces. These bodies were electron dense with a maximum diameter of 3 micrometer. The information we gathered from the patient history, the laboratory data and the various histochemical and immunohistochemical analyses failed to reveal the exact nature of these crystal-like structures.
Radiation-Induced Epithelial Proliferation Mimicking Invasive Carcinoma of the Urinary Bladder: A Report of 2 Cases.
Ok Jun Lee, Kyu Rae Kim, Dae Woon Eom, Hyun Jung Kim, Na Hye Myong, Jae Y Ro
Korean J Pathol. 2004;38(5):341-344.
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AbstractAbstract PDF
Radiation-induced epithelial proliferation in the urinary bladder mimicking urothelial carcinoma has received only a little attention in the literature. Herein, we describe two cases of radiation-induced epithelial proliferative changes, which mimicked invasive urothelial carcinoma. Cystoscopy revealed bullous or edematous mucosal changes with multiple hemorrhagic foci. Microscopically, we observed inverted epithelial proliferation, forming nests and cords extending into the lamina propria. The epithelial cells in these nests and cords exhibited enlarged, hyperchromatic and pleomorphic nuclei, closely mimicking the infiltrative growth of urothelial carcinoma. However, the presence of radiation-induced changes was validated by the observation of abundant vacuolated cytoplasm, normal or slightly increased nuclear to cytoplasmic ratios, the absence of mitotic activity, dilated blood vessels containing frequent fibrin thrombi, scattered atypical fibroblasts, and the patients' previous history of radiation treatment. Radiation-induced changes should be always included in differential diagnoses of proliferative epithelial lesions in the urinary bladder and a pertinent clinical history of radiotherapy should be searched.
Dedifferentiated Chondrosarcoma with Giant Cell-rich Sarcomatous Component Resembling Giant Cell Tumor: A Case Report.
Pil Gyu Hwang, Jae Kyung Won, Min A Kim, Han Soo Kim, Sang Hoon Lee, Chong Jai Kim
Korean J Pathol. 2004;38(5):345-349.
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AbstractAbstract PDF
Dedifferentiated chondrosarcoma is an uncommon bone tumor, defined as a tumor in which two components -a low-grade chondrosarcoma and a high-grade non-cartilaginous sarcoma-coexist with abrupt interface. We report a rare case of giant-cell rich dedifferentiated chondrosarcoma occurred in the right distal femur shaft of a 60 year-old female. The plain X-ray film showed an irregular radiolucent mass. The T2-weighted MRI revealed a heterogeneous high signal intensity. It was an irregular mass composed of bluish-white, translucent chondroid elements and yellowish solid components with extraosseous invasion. Microscopically, a low-grade chondrosarcoma and a giant-cell rich spindle cell sarcoma with areas resembling giant cell tumor were recognized with abrupt transition. Immunohistochemical staining revealed a S100 protein positivity in chondroid cells and a few spindle cells. CD68 was strongly positive in giant cells. Vimentin was positive in both components and smooth muscle actin was positive in some spindle cells. There was no cytokeratin, desmin and myogenin immunopositivity. It is important to be aware of this rare variant of dedifferentiated chondrosarcoma to avoid the misdiagnosis of more common bone tumors including giant cell tumors.
Extraskeletal Osteosarcoma of the Posterior Mediastinum: A Case Report.
Weon Cheol Han, Hyang Jung Cho, Jai Kyoo Lee, Hyung Bae Moon, Jae Y Ro
Korean J Pathol. 2004;38(5):350-352.
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AbstractAbstract PDF
Extraskeletal osteosarcoma is a rare malignant tumor of soft tissue. In addition, there are only several cases of osteosarcoma of the mediastinum as a primary site in the world. We report a case of extraskeletal osteosarcoma arising in the posterior mediastinum. A 54-year-old man visited our hospital because of chest pain. Chest CT showed a 12 cm sized huge mediastinal mass. The mass revealed solid and ivory-colored cut surface with multifocally ovoid cystic spaces and hemorrhage. Microscopically, the tumor consisted of polygonal stromal cells, giant cells and varying amounts of neoplastic new bone, and mitotic figures were frequently observed. There were no distant metastasis and regional lymph node involvement.
Mixed Ductal-Endocrine Carcinoma of the Pancreas: A Case Report.
Ok Jun Lee, Yong Mee Cho, Hyang Im Lee, Duck Jong Han, Jae Y Ro
Korean J Pathol. 2004;38(5):353-356.
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AbstractAbstract PDF
Mixed ductal-endocrine carcinoma of the pancreas is composed of ductal and endocrine carcinoma components and each component makes up a significant proportion in the primary tumor as well as in the tumor of metastatic sites. Mixed ductal-endocrine pancreatic carcinoma is exceptionally rare and, to our knowledge, only five cases have been reported in the literature. Recently we experienced a case of mixed ductal-endocrine pancreatic carcinoma with regional lymph node and hepatic metastases in a 63-year-old woman. Here, we report a case of mixed ductal-endocrine pancreatic carcinoma with a review of the literature.

JPTM : Journal of Pathology and Translational Medicine