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Volume 49(1); January 2015
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Letter to the editor
TdT+ T-Lymphoblastic Proliferation in Castleman Disease
Chang Gok Woo, Jooryung Huh
J Pathol Transl Med. 2015;49(1):1-4.   Published online January 15, 2015
DOI: https://doi.org/10.4132/jptm.2014.11.17
  • 9,120 View
  • 113 Download
  • 9 Citations
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Reviews
Molecular Imaging in the Era of Personalized Medicine
Kyung-Ho Jung, Kyung-Han Lee
J Pathol Transl Med. 2015;49(1):5-12.   Published online January 15, 2015
DOI: https://doi.org/10.4132/jptm.2014.10.24
  • 10,181 View
  • 179 Download
  • 21 Citations
AbstractAbstract PDF
Clinical imaging creates visual representations of the body interior for disease assessment. The role of clinical imaging significantly overlaps with that of pathology, and diagnostic workflows largely depend on both fields. The field of clinical imaging is presently undergoing a radical change through the emergence of a new field called molecular imaging. This new technology, which lies at the intersection between imaging and molecular biology, enables noninvasive visualization of biochemical processes at the molecular level within living bodies. Molecular imaging differs from traditional anatomical imaging in that biomarkers known as imaging probes are used to visualize target molecules-of-interest. This ability opens up exciting new possibilities for applications in oncologic, neurological and cardiovascular diseases. Molecular imaging is expected to make major contributions to personalized medicine by allowing earlier diagnosis and predicting treatment response. The technique is also making a huge impact on pharmaceutical development by optimizing preclinical and clinical tests for new drug candidates. This review will describe the basic principles of molecular imaging and will briefly touch on three examples (from an immense list of new techniques) that may contribute to personalized medicine: receptor imaging, angiogenesis imaging, and apoptosis imaging.
Genomic Landscapes of Pancreatic Neoplasia
Laura D. Wood, Ralph H. Hruban
J Pathol Transl Med. 2015;49(1):13-22.   Published online January 15, 2015
DOI: https://doi.org/10.4132/jptm.2014.12.26
  • 10,524 View
  • 103 Download
  • 12 Citations
AbstractAbstract PDF
Pancreatic cancer is a deadly disease with a dismal prognosis. However, recent advances in sequencing and bioinformatic technology have led to the systematic characterization of the genomes of all major tumor types in the pancreas. This characterization has revealed the unique genomic landscape of each tumor type. This knowledge will pave the way for improved diagnostic and therapeutic approaches to pancreatic tumors that take advantage of the genetic alterations in these neoplasms.
Original Articles
PHH3 as an Ancillary Mitotic Marker in Gastrointestinal Stromal Tumors
Yooju Shin, Jiyeon Hyeon, Boram Lee, Sang Yun Ha, Min Eui Hong, In Gu Do, Kyoung-Mee Kim
J Pathol Transl Med. 2015;49(1):23-29.   Published online January 15, 2015
DOI: https://doi.org/10.4132/jptm.2014.10.08
  • 7,621 View
  • 66 Download
  • 7 Citations
AbstractAbstract PDF
Background
Counting mitoses is subjective and time-consuming. The adjunctive diagnostic utility of a recently reported mitotic marker, phosphohistone H3 (PHH3), was investigated in gastrointestinal stromal tumors (GISTs). Methods: We reviewed 77 GISTs for several proliferative indices. These included the mitotic count per 50 high power fields (HPFs), the immunohistochemical Ki- 67 labeling index and the immunohistochemical PHH3 mitotic index (MI). For comparison, Spearman’s rank correlation and interclass correlation coefficient were used. Results: Mitotic counts ranged from 0–138 (mean, 7.57±2.34) and the PHH3 MI ranged from 0–126 per 50 HPFs (mean, 9.61±2.27). We found a positive correlation between mitotic counts and PHH3 MI (r=0.810, p<.001). The inter-observer correlation coefficient for three participants was 0.975 for mitotic counts and 0.940 for the PHH3 MI. When using the PHH3 MI instead of mitotic counts in the Armed Forces Institute of Pathology (AFIP) stratification criteria, 10 cases were reclassified. In one patient with a mitotic count of 2 and a PHH3 MI of 6 per 50 HPFs, distant metastasis occurred. Conclusions: In GISTs, the PHH3 MI correlated adequately with mitotic counts and can be used as a useful adjunctive to count mitotic figures efficiently.
Clinical and Prognostic Significances of Cytokeratin 19 and KIT Expression in Surgically Resectable Pancreatic Neuroendocrine Tumors
Eun-Mi Son, Joo Young Kim, Soyeon An, Ki-Byung Song, Song Cheol Kim, Eunsil Yu, Seung-Mo Hong
J Pathol Transl Med. 2015;49(1):30-36.   Published online January 15, 2015
DOI: https://doi.org/10.4132/jptm.2014.10.23
  • 9,268 View
  • 79 Download
  • 15 Citations
AbstractAbstract PDF
Background
Pancreatic neuroendocrine tumors (PanNETs) are malignant endocrine neoplasms that present diverse clinical behaviors. Therefore, identification of biomarkers of PanNETs is important for stratification of the prognosis of PanNET patients. Recently, cytokeratin 19 (CK19) and KIT expression were reported to have prognostic significance in PanNET patients. Methods: To identify their prognostic significance, CK19 and KIT protein expression were assessed in 182 surgically resected PanNETs and compared with clinicopathologic factors. Results: Of 182 PanNETs cases, CK19 and KIT expression was noted in 97 (53.3%) and 16 (8.8%) cases, respectively. PanNET patients with CK19 expression had larger tumors (p=.006), higher World Health Organization (WHO) grade (p=.002) and pT classification (p<.001), increased distant metastasis (p=.004), and lymphovascular (p=.012) and perineural (p=.019) invasion. Similarly, those with KIT expression had larger tumors (p=.030), higher WHO grade (p=.001), advanced pT classification (p<.001), distant metastasis (p=.001), and lymphovascular invasion (p=.014). The 5-year survival rate for PanNET patients with KIT expression was significantly lower (62%) than that of patients without KIT expression (77%, p=.011), as determined by univariate but not by multivariate analyses. Conclusions: CK19 and KIT expression correlate with higher metastatic potential and advanced disease stage, and KIT expression is associated with worse survival in PanNET patients.
Transglutaminase 2 Expression and Its Prognostic Significance in Clear Cell Renal Cell Carcinoma
Min Jee Park, Hae Woon Baek, Ye-Young Rhee, Cheol Lee, Jeong Whan Park, Hwal Woong Kim, Kyung Chul Moon
J Pathol Transl Med. 2015;49(1):37-43.   Published online January 15, 2015
DOI: https://doi.org/10.4132/jptm.2014.10.25
  • 7,504 View
  • 61 Download
  • 13 Citations
AbstractAbstract PDF
Background
A few recent studies have demonstrated a possible role of transglutaminase 2 (TG2) in tumorigenesis or progression of renal cell carcinoma (RCC). The aim of this study was to examine TG2 expression and its clinicopathologic significance in a large number of human clear cell RCCs (CCRCCs). Methods: We analyzed 638 CCRCC patients who underwent partial or radical nephrectomy between 1995 and 2005. The expression of TG2 was determined by immunohistochemistry and categorized into four groups, according to staining intensity: negative (0), mild (1+), moderate (2+), and strong (3+). Results: TG2 staining intensity was negative in 8.5% of CCRCC (n=54), 1+ in 32.6% (n=208), 2+ in 50.5% (n=322), and 3+ in 8.5% (n=54). Strong TG2 expression was correlated with high Fuhrman nuclear grade (p=.011), high T category (p=.049), metastasis (p=.043) and male sex (p<.001) but not with N category.The survival analysis showed a significant association between strong TG2 expression and worse overall and cancer-specific survival (p=.027 and p=.010, respectively). On multivariate analysis, strong TG2 expression was a marginally significant prognostic indicator for Fuhrman nuclear grade and TNM staging (p=.054). Conclusions: Our study is the first to demonstrate the clinicopathologic significance of TG2 expression in a large number of human CCRCC samples. Strong TG2 expression was associated with high nuclear grade and poor prognosis.
Expression of c-MET in Invasive Meningioma
Sumi Yun, Jae Moon Koh, Kyu Sang Lee, An Na Seo, Kyung Han Nam, Gheeyoung Choe
J Pathol Transl Med. 2015;49(1):44-51.   Published online January 15, 2015
DOI: https://doi.org/10.4132/jptm.2014.10.13
  • 7,620 View
  • 63 Download
  • 15 Citations
AbstractAbstract PDF
Background
Meningiomas show high recurrence rates even after curative tumor removal. The invasiveness of meningiomas may contribute to their high recurrence rates. Recently, c-MET and hepatocyte growth factor (HGF) have been reported to be involved in cancer invasion. Methods: We examined the immunohistochemical expression of c-MET and HGF in 100 cases of patients with meningiomas who have undergone complete tumor removal. Results: c-MET-High and HGFHigh were found in 17% and 13% of meningiomas, respectively. Brain invasion was observed in 17.6% of c-MET-High meningiomas, but in only 2.4% of c-MET-Low meningiomas (p=.033). Bone/ soft tissue invasion was observed in 23.5% of c-MET-High meningiomas and in 9.6% of c-MET-Low meningiomas (p=.119). HGF-High did not show statistical association with brain invasion or bone/ soft tissue invasion. c-MET-High demonstrated shorter recurrence-free survival (RFS, 93.5±8.2 months vs 96.1±1.9 months); however, this difference was not statistically significant (p=.139). There was no association of HGF-High with RFS. Conclusions: This study demonstrates that c- MET-High is associated with brain invasion of meningiomas, and that c-MET expression may be a useful predictive marker for meningioma recurrence. Patients with invasive meningiomas with high expressions of c-MET may be good candidates for targeted therapy using c-MET inhibitors.
Diagnostic Accuracy of Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology of Pancreatic Lesions
Hae Woon Baek, Min Jee Park, Ye-Young Rhee, Kyoung Bun Lee, Min A Kim, In Ae Park
J Pathol Transl Med. 2015;49(1):52-60.   Published online January 15, 2015
DOI: https://doi.org/10.4132/jptm.2014.10.26
  • 7,875 View
  • 69 Download
  • 23 Citations
AbstractAbstract PDF
Background
Endoscopic ultrasound–guided fine needle aspiration cytology (EUS-FNAC) is currently the most commonly used procedure for obtaining cytologic specimens of the pancreas. It is accurate, minimally invasive, safe and cost-effective. However, there is discrepancy between cytological and surgical diagnoses. This study was aimed at evaluating the diagnostic accuracy of EUS-FNAC of the pancreas. Methods: We performed a retrospective review of 191 cases of pancreatic lesions initially diagnosed by EUS-FNAC with subsequent histological diagnosis between 2010 and 2012 in the Department of Pathology, Seoul National University Hospital. Cytologic and surgical diagnoses were categorized into five groups: negative, benign, atypical, malignant, and insufficient for diagnosis. Subsequently, 167 cases with satisfactory yield in both surgical and cytology specimens were statistically analyzed to determine correlations with diagnosis. Results: In comparison to surgical diagnoses, cytologic diagnoses were true-positive in 103 cases (61.7%), true-negative in 28 cases (16.8%), false-positive in 9 cases (5.4%), and false-negative in 27 cases (16.1%). The diagnostic accuracy was 78.4%, sensitivity was 79.2%, and specificity was 75.7%. The positive predictive value was 92.0%, and negative predictive value was 50.9%. Conclusions: EUS-FNAC has high accuracy, sensitivity, specificity and positive predictive value. Overcoming the limitations of EUS-FNAC will make it a useful and reliable diagnostic tool for accurate evaluation of pancreatic lesions.
Brief Case Reports
Mixed Carcinoid-Mucinous Adenocarcinoma Arising in Mature Teratoma of Mesentery
Su-Jin Shin, Eun-Mi Son, Chang Ohk Sung, Kyu-Rae Kim
J Pathol Transl Med. 2015;49(1):61-65.   Published online January 15, 2015
DOI: https://doi.org/10.4132/jptm.2014.09.17
  • 9,045 View
  • 77 Download
  • 2 Citations
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Ewing’s Sarcoma/Primitive Neuroectodermal Tumor of the Uterine Corpus
Eung-Seok Lee, Won Hwangbo, Insun Kim
J Pathol Transl Med. 2015;49(1):66-70.   Published online January 15, 2015
DOI: https://doi.org/10.4132/jptm.2014.10.14
  • 9,457 View
  • 73 Download
  • 4 Citations
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Placental Mesenchymal Dysplasia with Fetal Gastroschisis
Binnari Kim, Jiyeon Hyeon, Minju Lee, Hyewon Hwang, Yooju Shin, Suk-Joo Choi, Jung-Sun Kim
J Pathol Transl Med. 2015;49(1):71-74.   Published online January 15, 2015
DOI: https://doi.org/10.4132/jptm.2014.12.14
  • 9,506 View
  • 80 Download
  • 2 Citations
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A Rare Case of Mixed Type A Thymoma and Micronodular Thymoma with Lymphoid Stroma
Yoon Jin Cha, Joungho Han, Jimin Kim, Kyung Soo Lee, Young Mog Shim
J Pathol Transl Med. 2015;49(1):75-77.   Published online January 15, 2015
DOI: https://doi.org/10.4132/jptm.2014.10.27
  • 8,792 View
  • 78 Download
  • 7 Citations
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A Rare Case of Tumor-to-Tumor Metastasis of Thyroid Papillary Carcinoma within a Pulmonary Adenocarcinoma
Taebum Lee, Yoon Jin Cha, Sangjeong Ahn, Joungho Han, Young Mog Shim
J Pathol Transl Med. 2015;49(1):78-80.   Published online January 15, 2015
DOI: https://doi.org/10.4132/jptm.2014.12.15
  • 7,299 View
  • 52 Download
  • 7 Citations
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Alveolar Rhabdomyosarcoma of the Lip in an Adult with Clear Cell Features
Jae Yeon Seok, Juhyeon Jeong, Young Woo Cheon, Hyun Yee Cho, Seung Yeon Ha, Dong Hae Chung
J Pathol Transl Med. 2015;49(1):81-84.   Published online January 15, 2015
DOI: https://doi.org/10.4132/jptm.2014.06.03
  • 10,131 View
  • 71 Download
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Squamous Cell Carcinoma of the Seminal Vesicle from Zinner Syndrome: A Case Report and Review of Literature
Younghoon Kim, Hae Woon Baek, Eunoh Choi, Kyung Chul Moon
J Pathol Transl Med. 2015;49(1):85-88.   Published online January 15, 2015
DOI: https://doi.org/10.4132/jptm.2014.10.28
  • 9,066 View
  • 60 Download
  • 6 Citations
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JPTM : Journal of Pathology and Translational Medicine