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Volume 43(4); August 2009
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Review Article
Liquid-Based Cytology in Gynecologic Cytology.
Yonghee Lee
Korean J Pathol. 2009;43(4):291-300.
DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.4.291
  • 2,408 View
  • 33 Download
  • 2 Citations
AbstractAbstract PDF
Conventional cervical smears have been a great tool to reduce the incidence of cervical cancer; however, many studies have revealed significant false negative rates. To resolve this problem, the liquid based cytology (LBC) method was developed. The LBC method reduces the number of false positive and false negative smear results because LBC achieves an even distribution of monolayered cells, eliminated the obscuring effects of inflammation and blood. Although the LBC method has many advantages, there are several drawbacks. The LBC method requires an adaptation period for cytopathologists and cytotechnicians. Another drawback is the expense of the method. Thus, the LBC method has been questioned, and criticism has been raised regarding the design of the studies that assert its superiority. With a focus on the cytomorphologic and technical differences of LBC compared with conventional cervical smears, a review of the clinical and cost effectiveness of LBC, a brief comparison of two popular LBC methods, and the basic concepts of study design with respect to LBC are presented in this review.
Original Articles
Columnar Cell Lesions in Fibrocystic Change of the Breast: The Incidence and Relationship with Microcalcifications.
Soo Im Choi, Hye Kyoung Yoon
Korean J Pathol. 2009;43(4):301-305.
DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.4.301
  • 3,559 View
  • 69 Download
AbstractAbstract PDF
BACKGROUND
Columnar cell lesions (CCLs) are characterized by the presence of columnar epithelial cells lining the terminal duct lobular units of the breast and frequently found in biopsies for microcalcifications. Their incidence and relationship with other lesions and the locations of microcalcifications have not been established. METHODS: We reviewed 1,038 cases of fibrocystic change (FCC) for the degrees of CCLs and ductal proliferative change (PC) and the locations of microcalcifications. RESULTS: Among 1,038 FCC cases, CCLs were found in 18.9%, columnar cell change (CCC) in 12.5%, columnar cell hyperplasia (CCH) in 5.3% and flat epithelial atypia (FEA) in 1.1%. CCLs were found in 14.2%, 28.8%, and 40.0% of non-PC (NPC), proliferative disease (PD) without atypia and PD with atypia, respectively. Microcalcifications were found in 33.5%, 56.2%, 61.8%, and 81.8% of caese without CCLs, with CCC, CCH and FEA, respectively. Their locations were in NPC in 66.3% of the cases, PD in 14.8% of the cases or both areas in 18.8% of FCC. CONCLUSIONS: The incidence of CCLs increased according to the degree of PD without positive correlation between the degree of CCLs and PD. The frequency of microcalcifications increased according to the degree of CCLs but was statistically insignificant. There is a possibility that a needle biopsy targeting a microcalcification area might leave additional PD around the targeted area because microcalcifications were found more frequently in NPC than PD area.
eNOS Gene Polymorphisms in Perinatal Hypoxic-Ischemic Encephalopathy.
Min Cho, Kwang Sun Hyun, David Chanwook Chung, In Young Choi, Myeung Ju Kim, Young Pyo Chang
Korean J Pathol. 2009;43(4):306-311.
DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.4.306
Retraction in: J Pathol Transl Med 2019;53(5):345
  • 65,535 View
  • 15,226 Download
  • 1 Citations
Detection of SV40 Large T Antigen in Malignant Lymphomas.
Young A Kim, MeeSoo Chang, Jinho Paik, Sun Och Yoon, Yoon Kyung Jeon, Chul Woo Kim, Ji Eun Kim
Korean J Pathol. 2009;43(4):312-316.
DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.4.312
  • 3,167 View
  • 54 Download
  • 1 Citations
AbstractAbstract PDF
BACKGROUND
The association of simian virus 40 (SV40) with certain types of human cancers, including malignant lymphomas, has been a topic of interest for some time. Although the virus is distributed worldwide, its incidences vary according to the specific types of tumors, and the epidemiological areas. The aim of this study was to investigate the frequency of SV40 in malignant lymphomas among Korean patients. METHODS: One hundred seventy three cases of malignant lymphomas were evaluated by immunohistochemical staining for SV40 large T antigen (TAg), using an extremely sensitive, tyramide based, catalyzed signal amplification method. RESULTS: From 158 non-Hodgkin's lymphomas, including 115 diffuse large B-cell lymphomas, and 15 Hodgkin's lymphomas, none of the cases were positive for SV40 TAg. CONCLUSIONS: SV40 does not appear to be related to the pathogenesis of malignant lymphomas among Koreans.
Expression of P-glycoprotein and Apoptosis in Diffuse Large B-cell Lymphoma.
Ji Eun Kim, Young A Kim, Mee Soo Chang, Yunkyeong Jeon, JinHo Paik, Seon Og Yoon
Korean J Pathol. 2009;43(4):317-320.
DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.4.317
  • 2,714 View
  • 51 Download
AbstractAbstract PDF
BACKGROUND
Diffuse large B-cell lymphoma (DLBCL) is the most common type of malignant lymphoma which responds well to conventional chemotherapy. However, quite a few patients have a recurrence with more aggressive forms after completion of therapy. Multidrug resistance proteins (MRP) are related to this process in several ways such as cell cycle alteration and modulation of apoptosis. METHODS: We investigated the expression of P-glycoprotein (Gp), one of the well-known MRP, as well as apoptosis associated proteins in DLBCL. Immunohistochemical staining for Gp, p53, Bcl-2, Ki-67, active caspase 3 and FADD was done in forty DLBCL cases. The association between MRP and apoptosis associated proteins to clinical findings was also tested. RESULTS: Twenty-nine patients out of 40 (73%) with DLBCL were positive for Gp, and 26 cases (65%) had a strong positive for Gp. Gp expression was stronger in high-grade lesions than in low-grade lesions and was associated to Bcl-2 expression. However, we could not find an adverse impact of Gp expression on patients' overall survival or relapse free survival rate. CONCLUSIONS: Our study revealed a high frequency of expression for Gp in DLBCL with a possible relationship between the expressions of Gp to apoptosis associated proteins.
Expression of p63 and its Isoform, deltaNp63, in Non-Small Cell Lung Carcinoma.
Ick Doo Kim, Dong Hoon Shin, Kyung Un Choi, Do Youn Park, Gi Yeong Huh, Mee Young Sol, Min Ki Lee, Young Dae Kim, Chang Hun Lee
Korean J Pathol. 2009;43(4):321-328.
DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.4.321
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AbstractAbstract PDF
BACKGROUND
Several studies have been conducted on the role of the p63 gene family in non-small cell lung carcinoma (NSCLC). Nevertheless, the role of these genes in the development and progression of NSCLC remains controversial. This study was designed to examine the expression and clinicopathologic significance of the p63 family in NSCLC.
METHODS
Immunohistochemical staining was performed on 92 cases of NSCLC (47 squamous cell carcinomas [SqCCs] and 45 adenocarcinomas [ACs]) using tissue microarray blocks. The results were analyzed and correlated with clinicopathologic data. RESULTS: The expression of delta Np63 (Delta Np63) was elevated in SqCC (39/47), but not in AC (2/45; p<0.01). Both p63 and Delta Np63 had high expression in 39 SqCCs; p63 and Delta Np63 also had a similar geomorphologic distribution in most positive tumors. The expression of Delta Np63 was correlated with histologic type, gender, pT stage, p53 expression, and p63 expression. pT and pN stages were independent factors in survival (p<0.05, respectively).
CONCLUSIONS
The major p63 isoform in NSCLC, Delta Np63, had a strong correlation with p53 and p63, and was exclusively expressed in SqCC. However, our findings suggest that Delta Np63 was not an independent prognostic factor for NSCLC.
Expression of Survivin in Gastric Carcinoma and its Relation to Tumor Cell Proliferation and Apoptosis.
Wan Sik Lee, Sung Bum Cho, Jong Sun Rew, Jae Hyuk Lee, Chang Soo Park, Young Eun Joo
Korean J Pathol. 2009;43(4):329-334.
DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.4.329
  • 2,524 View
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  • 1 Citations
AbstractAbstract PDF
BACKGROUND
Survivin, a novel antiapoptotic gene has been linked with tumor development and progression in various human carcinomas including gastric carcinomas. The aim of this study was to evaluate the expression of survivin in gastric carcinoma and its correlation with tumor cell proliferation and apoptosis. METHODS: Expression of survivin was evaluated immunohistochemically in 84 surgically resected gastric carcinomas. Tumor cell apoptosis was evaluated with terminal deoxynucleotidyl transferase (TdT) mediated deoxyuridine triphosphate (dUTP) nick-end labeling (TUNEL), and Ki-67 immunostaining was used for evaluation of tumor cell proliferation. RESULTS: Expression of survivin was noted in 53.6% of the gastric carcinomas, and was significantly associated with depth of invasion, status of lymph node metastasis or tumor stage (p=0.022, 0.034, 0.040, respectively). There was an inverse correlation between survivin expression and apoptotic index (p=0.015). But there was no significant correlation between survivin expression and Ki-67 labeling index (p=0.430). CONCLUSIONS: These results suggest that survivin expression may contribute to tumor development and progression by inhibiting apoptosis in human gastric carcinoma.
C1q Nephropathy: A Distinct Pathologic Entity.
Jung Ha Shin, Tae Eun Kim, Kyo Young Lee, Sang In Shim, Yeong Jin Choi
Korean J Pathol. 2009;43(4):335-341.
DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.4.335
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AbstractAbstract PDF
BACKGROUND
C1q nephropathy (C1qN) is a controversial diagnostic entity defined by Jennette and Hipp in 1985. The prevalence is very low and a few large scale studies have been reported. Application of the criteria for clinical diagnostics of C1qN may cause confusion with other glomerulonephropathies, such as minimal change disease (MCD) or focal segmental glomerulosclerosis (FSGS). In order to clarify the confusion with glomerulonephropathies, we did this study to identify the clinicopathological characteristics and the exact disease entity of C1qN.
METHODS
A total of 5,258 kidney biopsies at Kangnam St Mary's Hospital were reviewed. Twenty three cases (0.44%) met the criteria of C1qN. Twenty eight cases showing dominant C1q deposits without electron dense depostis (EDD) grouped as C1q+EDD-, and previously diagnosed typical cases of MCD and FSGS were selected for this study. Four groups were compared to each other with regard to the clinical and pathological aspects of the disease. RESULTS: C1qN patients had an average age of 30.4 years. Eighteen were males and 5 were females. Eighty seven percent had proteinuria and 18% had hematuria. By electron microscopy analysis, 100% had mesangial EDD and 47.8% showed foot process effacement. C1qN had some significant differences compared with C1q+EDD-, MCD and FSGS. CONCLUSIONS: C1qN is clinically and morphologically different from MCD and FSGS. However, additional long term studies are needed to fully define C1qN from other glomerulonephritis with C1q deposits.
Prevalence and Genotype Distribution of Cervical Human Papillomavirus DNA in Korean Women: A Multicenter Study.
Sung Ran Hong, In Sun Kim, Dong Won Kim, Mi Jin Kim, Ae Ree Kim, Young Ok Kim, Hye Sun Kim, Seo Hee Rha, Gyeong Sin Park, Yong Koo Park, Yong Wook Park, Ho Sung Park, Kwang Sun Suh, Jin Hee Sohn, Mi Kyung Shin, Hoon Kyu Oh, Ki Jung Yun, Hye Kyoung Yoon, Shi Nae Lee, Ah Won Lee, Hyo Jin Lee, Hyun Yee Cho, Chan Choi, Woon Won Jung
Korean J Pathol. 2009;43(4):342-350.
DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.4.342
  • 3,916 View
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  • 16 Citations
AbstractAbstract PDF
Background
DNA prevalence and type distribution of human papillomavirus (HPV) varies geographically. We investigated HPV prevalence and type distribution in Korean women using the MyHPV DNA chip testing. Methods: A total of 2,368 women from five regions of the country underwent Pap smear examination and MyHPV chip testing. Results: Overall HPV positivity was 15.8% and 78.4% in women with normal and abnormal cytology, respectively. High-risk HPV infection was strongly correlated with cytological atypia. In women with abnormal cytology, the five most common HPV types were 16, 58, 18, 52, and 56/53, and HPV16 was significantly the most common type in most geographical regions. After HPV16, HPV58, and 52 were the next most frequently detected types. Women with normal cytology, in contrast, showed heterogeneity in HPV type distribution. High-grade intraepithelial lesions infected with HPV16, 18, 31 or 45 are more likely to progress to carcinoma. Conclusions: The HPV chip test can provide useful data regarding HPV positivity and type. The most common HPV type in Korean women with abnormal cytology is HPV16, with HPV58 and 52 being frequently present. Our data may have important implications for vaccination programs and the development of cervical screening.
Case Report
Omental Histiocytic Sarcoma: A Case Report.
Sang Hak Han, Song Chul Kim, Min Hee Ryu, Chan Jeong Park, Joo Ryung Huh
Korean J Pathol. 2009;43(4):351-354.
DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.4.351
  • 2,128 View
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AbstractAbstract PDF
We report a case of perigastric histiocytic sarcoma (HS) involving the lesser omental sac in a 30-year-old man. HS is an exceedingly rare malignancy of mature tissue histiocyte. The tumor was a multi-lobulated, bulging enhancing mass in the lesser omentum with metastasis to lymph nodes and liver. The tumor consisted of diffuse non-cohesive proliferation of pleomorphic large oval to round neoplastic cells with giant cells showing vesicular chromatin and ample eosinophilic cytoplasm. In some areas, the tumor cells showed spindling with elongation of the nuclei and cellular shapes. Many of the tumor cells, especially giant forms contained phagocytosed lymphocytes. Immunohistochemical analysis of the tumor cells showed expression of leukocyte common antigen, CD68, lysozyme, vimentin, CD4, and CD163. Ki-67 index was 50-60%. After the operation, he was treated with chemotherapy, but the response was poor.
Short Case Report
Pneumocystis jirovecii Pneumonia Accompanied with Fat Embolism: A Case Report.
Sung Hak Lee, Ok Ran Shin, Eun Jung Lee, Kyo Young Lee
Korean J Pathol. 2009;43(4):355-357.
DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.4.355
  • 2,260 View
  • 17 Download
AbstractAbstract PDF
Pneumocystis jirovecii is an atypical fungus that causes severe pneumonia in immune compromised patients. While Pneumocystis jirovecii pneumonia (PCP) is more commonly diagnosed in individuals who have HIV infection, it can occur in individuals with other forms of immunosuppression. Fat embolism most commonly develops after orthopedic injuries, but it has also been reported after other forms of trauma such as severe burns, closed-chest cardiac massage, and liposuction. Overlap in the clinical presentation of these diseases has not yet been reported. We report here on a case of PCP with fat embolism in 52-year-old female patient who had no obvious risk factors for HIV infection. Even if risk factors for HIV or other forms of immunosuppression are not present, PCP can also be seen in patients who present with fat embolism, and the clinical presentation of both conditions can overlap.
Case Report
Malignant Glomus Tumors of the Stomach: A Report of 2 Cases with Multiple Metastases.
Hyunjoo Lee, Yoon Seok Choi, Sang Cheul Oh, Jong Jae Park, Chul Whan Kim, Han Kyeom Kim, Insun Kim
Korean J Pathol. 2009;43(4):358-363.
DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.4.358
  • 2,995 View
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  • 2 Citations
AbstractAbstract PDF
Glomus tumors are mesenchymal neoplasms usually developing in the dermis or subcutis of the extremities. The majority of glomus tumors are entirely benign, and malignant glomus tumors are very rare, especially those arising in the visceral organs. Here, we are presenting two cases of malignant glomus tumor, initially diagnosed in the stomach by endoscopic biopsy. Case 1 was found in the stomach, right kidney, brain and humerus of a 65-year-old woman, and Case 2 in the stomach and liver of a 63-year-old man. Histologically, the tumor was composed of solid sheets and nests of round and short-spindle shaped tumor cells with vesicular nucleus and prominent nucleolus. The tumor cells were closely admixed with blood vessels of varying size. Immunohistochemically, the tumor cells showed diffuse and strong positive staining for smooth muscle actin and paranuclear, dot-like staining for synaptophysin, but negative for desmin, c-kit, CD34 and S-100 protein. These two are rare cases of a malignant glomus tumor with widespread metastases.
Short Case Report
Pineal Parenchymal Tumor of Intermediate Differentiation with Gangliocytic Differentiation: A Case Report.
Lee So Maeng
Korean J Pathol. 2009;43(4):364-367.
DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.4.364
  • 2,276 View
  • 21 Download
  • 1 Citations
AbstractAbstract PDF
A 49-year-old man presented with an extremely rare case of pineal parenchymal tumor with gangliocytic cells, manifesting as progressive gait disturbance and urinary incontinence lasting for one year. Brain MRI revealed a homogenously enhancing mass, measuring 3.5x2.7 x1.7 cm, in the pineal body. The mass compressed the deep cerebral vein with superior displacement, which caused mild obstructive hydrocephalus. Histological examination revealed lobular structures consisting of isomorphic small round cells with stippled chromatin and clear cytoplasm, and less cellular areas having large pleomorphic cells and ganglioid cells. Mitotic figures and tumor necrosis were not evident. Immunohistochemically, the neoplastic cells were positive for neuronal markers (neuron-specific enolase, neurofilament, NeuN and synaptophysin), but not for glial fibrillary acidic protein or S-100. Especially, neurofilament showed diffuse interstitial immunoreactivity with accentuation in a few gangliocytic cells and Ki-67 labeling index (2.5%) was low. Therefore, this case was diagnosed as pineal parenchymal tumor of intermediate differentiation with gangliocytic differentiation.
Case Reports
Morphological Features of Metastatic Gastrointestinal Stromal Tumors after Gleevec Treatment: Two Cases Report.
Joon Hyuk Choi, Young Kyung Bae, Sun Kyo Song, Hong Jin Kim, Min Chul Shim, Kyung Hee Lee
Korean J Pathol. 2009;43(4):368-373.
DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.4.368
  • 2,483 View
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AbstractAbstract PDF
We report two patients with metastatic gastrointestinal stromal tumors (GISTs) with a focus on the morphological features related to Gleevec treatment. In case 1, a 50-year-old woman presented with a 1.8 cm metastatic GIST in the liver after resection of a gastric GIST. Majority of the metastatic tumor showed fibrosis and hyalinization after 8 weeks of Gleevec treatment. CD117-positive cells were present in approximately 1% of the overall tumor. In case 2, a 2 cm and 14 cm metastatic liver masses were found in a 54-year-old man who had a rectal GIST. After 4 weeks of Gleevec treatment, metastatic tumors showed a decrease in size on CT scan. The metastatic tumors showed a decrease in number of tumor cells. The hemorrhage, cystic changes, necrosis, and fibrosis made up approximately 90% of the tumor. The morphological features related to Gleevec treatment are important for correct diagnosis and evaluation of tumor response and prognosis.
Gastrointestinal Stromal Tumor of the Colon Mimicking Inflammatory Fibroid Polyp with a Novel 63 bp c-kit Deletion Mutation: A Case Report.
In Gu Do, Cheol Keun Park, Sung Hyun Yoon, John Goldblum, Kyoung Mee Kim
Korean J Pathol. 2009;43(4):374-377.
DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.4.374
  • 2,319 View
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AbstractAbstract PDF
Colonic gastrointestinal stromal tumors (GISTs) are rare and behave aggressively compared to GISTs in other parts of the gastrointestinal tract. Therefore, accurate diagnosis of GISTs and their distinction from other mesenchymal tumors is important for proper patient management and follow-up. Herein, we present an unusual case of a colonic GIST mimicking an inflammatory fibroid polyp with a novel 63 bp deletion mutation in exon 11 of the c-kit gene, which has not previously been reported. The tumor consisted of loosely arranged spindle cells and many inflammatory cells scattered throughout the tumor. Immunohistochemically, the tumor cells were focally and weakly positive for c-kit and diffusely positive for CD34, but were negative for PKC-theta, SMA, S-100 protein, ALK-1, and desmin. Our case re-emphasizes the broad morphologic spectrum of GISTs.

JPTM : Journal of Pathology and Translational Medicine