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Volume 45(4); August 2011
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Original Articles
Loss of PTEN Expression is an Independent Poor Prognostic Factor in Non-small Cell Lung Cancer.
Seol Bong Yoo, Xianhua Xu, Hyun Ju Lee, Sanghoon Jheon, Choon Taek Lee, Gheeyoung Choe, Jin Haeng Chung
Korean J Pathol. 2011;45(4):329-335.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.329
  • 3,628 View
  • 25 Download
  • 8 Citations
AbstractAbstract PDF
BACKGROUND
Alterations in the phosphatase and tensin homolog (PTEN) are correlated with tumor progression. Downregulation of PTEN is related to drug resistance of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors in non-small cell lung cancer (NSCLC). The aim of this study was to evaluate the prognostic significance of PTEN in patients with NSCLC and its correlation with EGFR.
METHODS
Two hundred eighty eight surgically resected NSCLC samples, including 168 adenocarcinomas (ADCs), 99 squamous cell carcinomas (SCCs) and 21 other NSCLCs were analyzed for the PTEN. The results were correlated with other clinicopathological variables including EGFR amplification and mutation.
RESULTS
Loss of PTEN was detected in 42.4% of NSCLCs, specifically 28.6% of ADCs, 66.7% of SCCs, and 38.1% of others. Loss of PTEN was significantly associated with SCC, smoking, male gender, and higher stage. In a multivariate analysis, loss of PTEN was significantly associated with short progression-free survival (p=0.037). No association between PTEN and EGFR was observed.
CONCLUSIONS
These results suggest that loss of PTEN results in shorter progression-free survival in patients with NSCLC, and loss of PTEN is more associated with SCC, smoking, male gender, and higher T stage by the 7th tumor, node and metastasis staging system but not EGFR status.
The Significance of Ventricular Volume in the Evaluation of Secondary Cardiomyopathy at Autopsy.
Joo Young Na, Byung Woo Min, Yeong Hui Kim, Seung Hyun Chung, Young Jik Lee, Hyung Seok Kim, Jong Tae Park
Korean J Pathol. 2011;45(4):336-347.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.336
  • 2,450 View
  • 11 Download
AbstractAbstract PDF
BACKGROUND
The weight, shape and consistency of the heart, and the thickness of the ventricular wall are used as parameters for evaluating postmortem heart and diagnosing cardiomyopathy at autopsy.
METHODS
The weight and volume of the ventricles and the thickness of the left ventricular wall of 58 hearts were measured and analyzed.
RESULTS
In the group of dilated hearts, the ventricular weight, ventricular volume, ventricular volume/ventricular weight, and left ventricular volume/right ventricular volume increased, whereas ventricular wall thickness decreased. In the group of hypertrophied hearts, the ventricular weight, ventricular volume, and thickness of the ventricular wall increased but ventricular volume/ventricular weight and left ventricular volume/right ventricular volume did not change significantly. In the group of undetermined hearts, it was later found that four of the cases should have been included in the dilated heart group and another two cases in the hypertrophied heart group.
CONCLUSIONS
In addition to conventional methods, the measuring ventricular volume is useful for evaluating a postmortem heart and may suggest postmortem differential diagnoses of dilated or hypertrophied forms of secondary cardiomyopathies.
Human Papillomavirus Prevalence in Gangwon Province Using Reverse Blot Hybridization Assay.
Dongsup Lee, Sunghyun Kim, Sangjung Park, Hyunwoo Jin, Tae Ue Kim, Kwang Hwa Park, Hyeyoung Lee
Korean J Pathol. 2011;45(4):348-353.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.348
  • 2,774 View
  • 21 Download
  • 6 Citations
AbstractAbstract PDF
BACKGROUND
Human papillomavirus (HPV) plays an important role in the development of cervical carcinoma. Although there is a general agreement that high levels of HPV are related to cervical cancer, the prevalence and distribution of HPV genotypes seems to vary by geographical region. This study was designed to investigate the prevalence of HPV genotypes in Gangwon Province, Korea.
METHODS
In total, 342 samples were examined by Pap smear and HPV-ID(R) reverse blot hybridization assay (REBA) (M&D, Wonju, Korea).
RESULTS
Overall HPV positivity was 80.9% and 64.4% in women with abnormal and normal cytology by REBA, respectively. The five most common HPV types were: HPV 16, 53, 58, 56, and 33 in samples with abnormal cytology, and HPV 16, 53, 58, 70, and 18 in samples with normal cytology.
CONCLUSIONS
The REBA can provide useful data regarding prevalence of HPV genotypes. Gangwon Province showed high prevalence of HPV infection in women. The most common HPV type in Gangwon Province was HPV16, and HPV 53, 58, 56, 70 were frequently present.
The Significance of MicroRNA Let-7b, miR-30c, and miR-200c Expression in Breast Cancers.
Sung Min Chun, Hee Jung Park, Chul Hwan Kim, Insun Kim
Korean J Pathol. 2011;45(4):354-360.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.354
  • 2,579 View
  • 35 Download
  • 1 Citations
AbstractAbstract PDF
BACKGROUND
MicroRNA (miRNA) is a class of noncoding protein RNA as a promising biomarker for various diseases. In this study, the expression of let-7b, miR-30c, and miR-200c was studied in breast cancer tissues to evaluate the potential relationship with known clinicopathological parameters.
METHODS
Quantitative real-time polymerase chain reaction was performed to determine the expression level of three miRNAs in 37 pairs of noncancerous normal and cancer tissues and an additional 38 cancer tissues from patients with invasive ductal carcinoma.
RESULTS
miR-200c expression was higher in cancer tissues compared to noncancerous normal tissues, and its ratio was correlated with patient age at surgery, type of surgery, and Ki-67 expression. The expression level of let-7b in cancer tissues was inversely correlated with lymph node metastasis, histological grade, and Ki-67 expression but positively correlated with estrogen and progesterone receptor expression. miR-200c expression level was positively correlated with Her-2 expression. The miR-30c expression level in breast cancer was not correlated with any parameters.
CONCLUSIONS
miR-200c and let-7b could be used as biomarkers in patients with breast cancer, but its pathological mechanism should be determined.
Association of CD57+ Natural Killer Cells with Better Overall Survival in DLBCL Patients.
Jeong Hyeon Lee, Yoon Jin Kwak, Chul Hwan Kim, Insun Kim
Korean J Pathol. 2011;45(4):361-370.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.361
  • 2,212 View
  • 19 Download
AbstractAbstract PDF
BACKGROUND
Malignant tumor cells may evoke the innate and adaptive immune systems. Various immune cells are involved in this immune reaction, and tumor infiltrating lymphocytes, macrophages, natural killer (NK) cells are associated with patient prognosis for solid tumors.
METHODS
Seventy-eight patients who were diagnosed with diffuse large B cell lymphoma (DLBCL) between 2001 and 2009 were selected. CD57+ NK cells, CD68+ tumor associated macrophages (TAMs), and CD4+ and CD8+ T cells were evaluated in tissue sections using immunohistochemical staining and compared with clinical parameters including age, gender, performance status, clinical stage, serum lactic dehydrogenase level, number of extranodal sites, international prognostic index score, chemotherapy response, and survival.
RESULTS
Patients with high numbers of CD57+ NK cells had a significantly higher overall survival rate than patients with low numbers of CD57+ NK cells. However, no significant difference was observed between the number of CD57+ NK cells and other prognostic parameters. The number of CD68+ TAMs and CD4+ or CD8+ T cells was not significantly correlated with prognostic factors in patients with DLBCL.
CONCLUSIONS
An evaluation of tumor infiltrating CD57+ NK cells is recommended as a prognostic indicator in patients with DLBCL.
Prognostic Significance and Nature of Rhabdoid Features in Renal Cell Carcinoma.
Misun Choe, Ji Young Park, Ilseon Hwang, Sang Pyo Kim
Korean J Pathol. 2011;45(4):371-378.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.371
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AbstractAbstract PDF
BACKGROUND
Recent reports have indicated that renal cell carcinoma (RCC) with rhabdoid features follows an aggressive clinical course. We investigated the prognostic significance and nature of the rhabdoid component.
METHODS
We retrospectively analyzed the incidence and clinicopathologic characteristics of RCC with rhabdoid features in 174 radical nephrectomy cases. The specimens were examined histologically and immunohistochemically.
RESULTS
Twelve of the 174 RCC cases (6.9%) showed rhabdoid features. Histologically, all the tumors with rhabdoid features were of the clear cell type. The presence of rhabdoid features was significantly associated with higher Fuhrman's nuclear grade and higher pathologic tumor stage at presentation. Among the 12 patients who showed the rhabdoid component, nine (75%) developed metastasis and seven (58.3%) died of disease-related causes. The presence of rhabdoid features was independently associated with metastasis and disease-related mortality. The rhabdoid cells were positive for vimentin; variably positive for pan-cytokeratin, epithelial membrane antigen, and CD10; and negative for cytokeratin 7, smooth muscle actin, desmin, E-cadherin, and c-Kit. No case showed loss of integrase interactor-1; one was p53 positive, and five were insulin-like growth factor mRNA binding protein 3 positive. The Ki-67 labeling index was 1-25% (mean, 5.5%).
CONCLUSIONS
The rhabdoid component is an independent prognostic factor for metastasis of RCC; therefore, identification of this component is critical.
Insulin-like Growth Factor II mRNA-Binding Protein 3 Expression in Benign and Premalignant Lesions and Carcinomas of the Stomach.
Dae Hyun Song, Jung Wook Yang, Dong Chul Kim, Jong Sil Lee, Jeong Hee Lee, Sang Ho Jeong, Gyung Hyuck Ko
Korean J Pathol. 2011;45(4):379-385.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.379
  • 2,774 View
  • 17 Download
  • 2 Citations
AbstractAbstract PDF
BACKGROUND
Recent studies have demonstrated that insulin-like growth factor II mRNA-binding protein 3 (IMP3) is expressed in malignant tumors of various organs but not in normal tissue. We investigated IMP3 expression in various benign lesions, premalignant lesions and carcinomas of the stomach.
METHODS
IMP3 immunohistochemical staining was performed on 24 benign gastric lesions, 24 gastric adenomas, and 322 gastric carcinomas.
RESULTS
IMP3 was not expressed in benign gastric lesions including adenomas with low-grade dysplasia, but was expressed in 17% of adenomas with high-grade dysplasia, and in 44% of carcinomas. As the carcinomas were in the advanced stage, they expressed IMP3 more frequently and strongly. Patients with IMP3-positive tumors had poorer survival than those with negative tumors.
CONCLUSIONS
IMP3 expression in gastric carcinoma may be related to tumor invasion and metastasis, and is an independent risk factor for poor prognosis.
The Histone Acetyltransferase hMOF is Overexpressed in Non-small Cell Lung Carcinoma.
Joon Seon Song, Sung Min Chun, Ji Young Lee, Dong Kwan Kim, Yong Hee Kim, Se Jin Jang
Korean J Pathol. 2011;45(4):386-396.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.386
  • 3,732 View
  • 46 Download
  • 12 Citations
AbstractAbstract PDF
BACKGROUND
One of the histone acetyltransferases (HATs) family of proteins, human MOF (hMOF, MYST1), is involved in histone H4 acetylation, particularly at lysine 16 (H4K16Ac), an epigenetic mark of active genes. Dysregulation of the epigenetic mark influences cellular biology and possibly leads to oncogenesis. We examined the involvement of hMOF and H4K16Ac in primary non-small cell lung cancer (NSCLC).
METHODS
Reverse transcription polymerase chain reaction using fresh-frozen lung cancer tissues and lung cancer cell lines and immunohistochemistry for hMOF and H4K16Ac via tissue microarray of 551 formalin-fixed paraffin-embedded NSCLC tissue blocks were conducted.
RESULTS
hMOF mRNA was frequently overexpressed in lung cancer tissues, compared with normal lung tissues (10/20, 50%). NSCLC tissues were positive for hMOF in 37.6% (184/489) and H4K16Ac in 24.7% (122/493) of cases. hMOF protein expression was tightly correlated with the H4K16Ac level in tumors (p<0.001). Knockdown of hMOF mRNA with siRNA led to a significant inhibition of growth in the Calu-6 cell line.
CONCLUSIONS
hMOF was frequently expressed in NSCLC and was correlated with H4K16Ac. To our knowledge, this is the first study that has focused on the expression status of HATs and hMOF in NSCLC. Our results clearly suggest a potential oncogenic role of the gene and support its utility as a potential therapeutic target.
Inhibitors of Apoptosis Proteins Expression and Their Prognostic Significance in Colorectal Carcinoma.
Kyung Hwa Lee, Soong Lee, Hyeon Min Lee, Seung Chul Back, Sung Bum Cho, Jae Hyuk Lee
Korean J Pathol. 2011;45(4):397-405.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.397
  • 2,860 View
  • 14 Download
  • 1 Citations
AbstractAbstract PDF
BACKGROUND
The expression of the inhibitor of apoptosis proteins (IAPs) family has not been fully investigated in colorectal carcinomas. This study investigated IAP expression in colorectal carcinomas and assessed their prognostic significance.
METHODS
Livin, XIAP, and SMAC/DIABLO expression was assessed by immunohistochemistry in 159 colorectal carcinomas. Correlations between protein expression and clinicopathological features were evaluated. The survival data analysis was estimated according to the Kaplan-Meier method.
RESULTS
Increased expression of IAPs in cancer tissues compared to surrounding nonneoplastic counterparts was observed in 67 cases (42.1%) for Livin, 50 cases (31.4%) for XIAP, and 68 cases (42.8%) for SMAC. A significant correlation was found between Livin expression and tumor differentiation, and SMAC expression and tumor location. The recurrence-free and overall survival of patients with low Livin expression were inferior to those of patients with high Livin expression (p=0.054 and 0.095, respectively). High XIAP expression was significantly associated with shorter progression-free survival (p= 0.041).
CONCLUSIONS
Our study demonstrated that altered expression of IAP family members, including Livin, XIAP, and SMAC, is frequent in colorectal carcinoma. This result suggests that high Livin expression and low XIAP expression may be a favorable prognostic implication related to patient survival.
Fine-Needle Aspiration Cytology of the Nodal Marginal Zone Lymphoma.
Seung Kyu Choi, Ji Eun Kwon, Young Hyeh Ko
Korean J Pathol. 2011;45(4):406-411.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.406
  • 2,475 View
  • 12 Download
AbstractAbstract PDF
BACKGROUND
Nodal marginal zone lymphoma (NMZL) is a rare B-cell neoplasm consisting of heterogeneous cellular components and residual B-cell follicles. Because of such histological features, it is difficult to diagnose NMZL by fine needle aspiration (FNA) cytology. We reviewed FNA cytology of NMZL to identify a cytological clue to avoid misdiagnosing NMZL.
METHODS
Histological, cytological, and clinical findings of seven cases of NMZL were reviewed.
RESULTS
Most cases showed nodular aggregates of lymphohistiocytes derived from the germinal center irrespective of histological pattern. The cellular components were heterogeneous and composed of mature small lymphocytes, intermediate and large lymphocytes, immunoblasts, tingible body macrophages, and follicular dendritic cells. Intermediate-sized neoplastic cells with a pale nucleus were observed but difficult to identify because of admixed non-neoplastic cells, which outnumbered neoplastic cells. Except for one case with a high proportion of intermediate-sized cells, the other six cases were initially diagnosed as reactive hyperplasia. A flow cytometric analysis was performed in two cases and failed to demonstrate a monoclonal B-cell population.
CONCLUSIONS
The FNA showing a reactive hyperplasia-like smear pattern should be carefully observed by experienced cytopathologists to identify intermediate-sized neoplastic cells. Clinical information including the size of the lymph nodes is important to avoid a misdiagnosis.
Case Reports
Parotid Gland Carcinosarcoma with Osteosarcoma as a Sarcomatous Component: A Case Report with Fine Needle Aspiration Cytologic Findings.
Se Min Jang, Young Jin Jun, Hulin Han, Ki Seok Jang, Seung Sam Paik
Korean J Pathol. 2011;45(4):412-416.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.412
  • 2,808 View
  • 30 Download
  • 1 Citations
AbstractAbstract PDF
Carcinosarcoma of the salivary glands is a rare malignant tumor showing both malignant epithelial and mesenchymal components. Herein, we present a carcinosarcoma of the parotid gland in a 67-year-old man consisting of osteosarcoma and adenocarcinoma components with fine needle aspiration cytological findings. The tumor was composed predominantly of osteosarcoma and small areas of adenocarcinomatous components and a hyalinized nodule reminiscent of pleomorphic adenoma. The tumor showed infiltrative growth features with perineural, lymphatic, and vascular invasion. Despite postoperative adjuvant radiation therapy, multiple metastatic lesions occurred in the both lungs 5 months after surgery. As salivary gland carcinosarcoma has been known to demonstrate highly aggressive behavior, an accurate pathological diagnosis is prerequisite for appropriate treatment.
Diffuse Large B-Cell Lymphoma Associated with Chronic Inflammation Manifested as a Soft Tissue Mass: Incidental Discovery on Histological Examination.
Sang Yun Ha, Yoon La Choi, Sung Joo Kim, Young Hye Ko
Korean J Pathol. 2011;45(4):417-422.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.417
  • 3,012 View
  • 23 Download
  • 4 Citations
AbstractAbstract PDF
We report an extraordinary case of diffuse large B-cell lymphoma arising in a cystic necrotic mass in a 35-year-old man who presented with a soft tissue mass at the site of previous surgery. A benign mass was surgically removed 17 years ago, after which a cystic lesion gradually developed at the same site. The resected mass appeared as a thick-walled cyst filled with brown necrotic and hemorrhagic material. On microscopic examination, the cyst wall was primarily necrotic tissue with some aggregates of large atypical lymphoid cells. These atypical cells were diffusely positive for CD20 and showed a high proliferation index, Epstein-Barr virus positivity, and clonal rearrangement of the immunoglobulin gene. His present condition was diagnosed as Epstein-Barr virus-associated diffuse large B-cell lymphoma arising from chronic inflammation. It is important to be aware of the clinical manifestations and histological features of this rare disease in light of diagnosis and treatment.
Primary Hepatic Neuroblastoma: A Case Report.
Geunyoung Jung, Jihun Kim
Korean J Pathol. 2011;45(4):423-427.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.423
  • 3,140 View
  • 17 Download
  • 1 Citations
AbstractAbstract PDF
Neuroblastoma is a malignant tumor of primordial neural crest origin. It usually develops along the sympathetic nervous system, such as the adrenal glands or paramedian sympathetic chain and metastasizes to the liver most frequently. However, a primary hepatic neuroblastoma has not been reported yet. Here, we report a case of 29-year-old woman who presented with a solitary hepatic mass. Grossly, the mass was large, creamy, rubbery firm, and showed focal hemorrhage and central cavitation. Microscopically, the tumor cells were arranged in small nests of spindle to ovoid cells with abundant neuropil. The neuroblastic nature of the tumor was confirmed by immunohistochemistry and electron microscopy. No extrahepatic mass was found, despite a thorough systemic survey such as chest and abdominopelvic computed tomography (CT) scans and a whole body positron emission tomography-CT study. To the best of our knowledge, this is the first report of a bona fide primary hepatic neuroblastoma.
Cytologic Features and BRAF Mutation of Hyalinizing Trabecular Adenoma of the Thyroid: A Case Report with Review of the Literature.
Se Min Jang, Young Ha Oh, Yoon Kyung Jeon, Yong Wook Park, Moon Hyang Park
Korean J Pathol. 2011;45(4):428-433.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.428
  • 2,715 View
  • 24 Download
  • 2 Citations
AbstractAbstract PDF
A hyalinizing trabecular adenoma (HTA) is a rare benign thyroid tumor of follicular epithelial cell origin with a trabecular-alveolar growth pattern and marked intratrabecular hyalinization. The cytological and histological features of HTA are very similar to those of papillary and medullary carcinomas of the thyroid. Therefore, an accurate diagnosis of HTA is important to avoid unnecessary and potentially harmful management of patients. However, the results of BRAF gene mutation analysis shown by many studies are distinctly different between HTAs and papillary thyroid carcinomas. Herein, we describe a rare case of HTA of the thyroid in a 49-year-old female and consider its characteristic cytological features and BRAF gene mutation analysis results with a brief review of the literature.
Bile Ductular Proliferation in the Gastric Wall after Gastric Ulcer Penetration into the Liver.
Eun Jung Cha
Korean J Pathol. 2011;45(4):434-436.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.434
  • 2,139 View
  • 10 Download
AbstractAbstract PDF
Liver penetration is one of the most serious complications of peptic ulcer diseases but is rarely encountered. A 57-year-old man was admitted to our hospital for further evaluation of a gastric malignancy. One month before admission, he was diagnosed with an adenocarcinoma by endoscopic biopsy at other hospital. A subtotal gastrectomy was performed to confirm malignancy and relieve the epigastric pain. Histologically, single glands were located between the ulcer base and attached liver tissue and stained positively for cytokeratin 19. The pathologic diagnosis was a gastric ulcer and bile ductular proliferation in the liver and gastric wall. Here, this report is the first Korean case of liver penetration of a gastric ulcer.

JPTM : Journal of Pathology and Translational Medicine