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Volume 49(2); March 2015
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Reviews
Utility of Transmission Electron Microscopy in Small Round Cell Tumors
Na Rae Kim, Seung Yeon Ha, Hyun Yee Cho
J Pathol Transl Med. 2015;49(2):93-101.   Published online March 12, 2015
DOI: https://doi.org/10.4132/jptm.2015.01.30
  • 12,625 View
  • 242 Download
  • 4 Citations
AbstractAbstract PDF
Small round cell tumors (SRCTs) are a heterogeneous group of neoplasms composed of small, primitive, and undifferentiated cells sharing similar histology under light microscopy. SRCTs include Ewing sarcoma/peripheral neuroectodermal tumor family tumors, neuroblastoma, desmoplastic SRCT, rhabdomyosarcoma, poorly differentiated round cell synovial sarcoma, mesenchymal chondrosarcoma, small cell osteosarcoma, small cell malignant peripheral nerve sheath tumor, and small cell schwannoma. Non-Hodgkin’s malignant lymphoma, myeloid sarcoma, malignant melanoma, and gastrointestinal stromal tumor may also present as SRCT. The current shift towards immunohistochemistry and cytogenetic molecular techniques for SRCT may be inappropriate because of antigenic overlapping or inconclusive molecular results due to the lack of differentiation of primitive cells and unavailable genetic service or limited moleculocytogenetic experience. Although usage has declined, electron microscopy (EM) remains very useful and shows salient features for the diagnosis of SRCTs. Although EM is not always required, it provides reliability and validity in the diagnosis of SRCT. Here, the ultrastructural characteristics of SRCTs are reviewed and we suggest that EM would be utilized as one of the reliable modalities for the diagnosis of undifferentiated and poorly differentiated SRCTs.
Role of Osteal Macrophages in Bone Metabolism
Sun Wook Cho
J Pathol Transl Med. 2015;49(2):102-104.   Published online March 12, 2015
DOI: https://doi.org/10.4132/jptm.2015.02.02
  • 8,409 View
  • 110 Download
  • 14 Citations
AbstractAbstract PDF
Macrophages have been shown to have pleiotropic functions in various pathophysiologies, especially in terms of anti-inflammatory and regenerative activity. Recently, the novel functions of bone marrow resident macrophages (called osteal macrophages) were intensively studied in bone development, remodeling and tissue repair processes. This review discusses the current evidence for a role of osteal macrophages in bone modeling, remodeling, and fracture healing processes.
Original Articles
Overexpression of C-reactive Protein as a Poor Prognostic Marker of Resectable Hepatocellular Carcinomas
Jin Ho Shin, Chong Jai Kim, Eun Jeong Jeon, Chang Ohk Sung, Hwa Jeong Shin, Jene Choi, Eunsil Yu
J Pathol Transl Med. 2015;49(2):105-111.   Published online March 12, 2015
DOI: https://doi.org/10.4132/jptm.2015.01.19
  • 9,531 View
  • 71 Download
  • 14 Citations
AbstractAbstract PDF
Background
C-reactive protein (CRP) is an acute phase reactant synthesized in the liver. CRP immunoreactivity is a feature of inflammatory hepatocellular adenomas with a higher risk of malignant transformation. A high serum CRP level denotes poor prognosis in hepatocellular carcinoma (HCC) patients. This study was conducted to determine whether CRP is produced in HCC and to assess the clinicopathologic significance of CRP expression in cancer cells. Methods: CRP immunoreactivity was examined in treatment-naïve HCCs (n=224) using tissue microarrays and was correlated with clinicopathologic parameters. The expression of CRP mRNA and protein was also assessed in 12 HCC cases by quantitative real-time polymerase chain reaction and immunoblotting. Hep3B and SNU-449 HCC cell lines were used for the analysis of CRP mRNA regulation by interleukin 6 (IL-6). Results: CRP was expressed in 133 of 224 HCCs (59.4%) with a variable degree of immunoreactivity (grade 1 in 25.9%; grade 2 in 20.1%; grade 3 in 13.4%). There was an inverse relationship between grade 3 CRP immunoreactivity and cancer-specific survival (p=.0047), while no associations were found with other parameters, including recurrence-free survival. The CRP mRNA expression level was significantly higher in CRP immunopositive cases than in immunonegative cases (p<.05). CRP mRNA expression was increased in Hep3B cells, but was not detected in SNU-449 cells even after IL-6 treatment. Conclusions: We report the expression of CRP in HCC for the first time. CRP expression was associated with poor cancer-specific survival in patients with resectable HCC.
The Diagnostic Usefulness of HMGA2, Survivin, CEACAM6, and SFN/14-3-3 δ in Follicular Thyroid Carcinoma
Min Hye Jang, Kyeong Cheon Jung, Hye Sook Min
J Pathol Transl Med. 2015;49(2):112-117.   Published online March 12, 2015
DOI: https://doi.org/10.4132/jptm.2015.01.31
  • 6,921 View
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  • 11 Citations
AbstractAbstract PDF
Background
Follicular thyroid carcinoma (FTC) is the second most common thyroid malignancy and its differential diagnosis includes follicular adenoma (FA) and adenomatous goiter (AG). Several ancillary markers have been suggested to aid in the diagnosis of FTC, but the successful use of these methods still needs to be validated. Methods: In the present study, we verified the immunoexpression of HMGA2, CEACAM6, survivin, and SFN/14-3-3 δ in lesions including 41 AGs, 72 FAs, and 79 FTCs. We evaluated their diagnostic usefulness, combined with galectin 3, Hector Battifora mesothelial 1 (HBME1), cytokeratin 19, and cyclin D1, in diagnosing FTC. Results: The expressions of HBME1 (65.8%) and HMGA2 (55.7%) were significantly higher in FTCs than in FAs and AGs (p<.001 and p=.005, respectively). HBME1 was the only marker that was more frequently expressed in FTCs than in FAs (p=.021) and it was more frequently expressed in follicular neoplasms than in AGs (p<.001). Among the novel markers, the combination of HMGA2 and HBME1 showed the highest sensitivity (72.2%) and specificity (76.1%) for diagnosing FTC. CEACAM6, survivin, and SFN/14-3-3 δ were barely expressed in most cases. Conclusions: Our present results show that only HMGA2 can be beneficial in differentiating FTC using the novel markers.
Pathologic Factors Associated with Prognosis after Adjuvant Chemotherapy in Stage II/III Microsatellite-Unstable Colorectal Cancers
Jung Ho Kim, Jeong Mo Bae, Hyeon Jeong Oh, Hye Seung Lee, Gyeong Hoon Kang
J Pathol Transl Med. 2015;49(2):118-128.   Published online March 12, 2015
DOI: https://doi.org/10.4132/jptm.2015.02.05
  • 9,442 View
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  • 14 Citations
AbstractAbstract PDF
Background
Although there are controversies regarding the benefit of fluoropyrimidine-based adjuvant chemotherapy in patients with microsatellite instability–high (MSI-H) colorectal cancer (CRC), the pathologic features affecting postchemotherapeutic prognosis in these patients have not been fully identified yet. Methods: A total of 26 histopathologic and immunohistochemical factors were comprehensively evaluated in 125 stage II or III MSI-H CRC patients who underwent curative resection followed by fluoropyrimidine-based adjuvant chemotherapy. We statistically analyzed the associations of these factors with disease-free survival (DFS). Results: Using a Kaplan- Meier analysis with log-rank test, we determined that ulceroinfiltrative gross type (p=.003), pT4 (p<.001), pN2 (p=.002), perineural invasion (p=.001), absence of peritumoral lymphoid reaction (p=.041), signet ring cell component (p=.006), and cribriform comedo component (p=.004) were significantly associated with worse DFS in patients receiving oxaliplatin-based adjuvant chemotherapy (n=45). By contrast, pT4 (p<.001) and tumor budding-positivity (p=.032) were significant predictors of poor survival in patients receiving non-oxaliplatin–based adjuvant chemotherapy (n=80). In Cox proportional hazards regression model-based univariate and multivariate analyses, pT category (pT1-3 vs pT4) was the only significant prognostic factor in patients receiving non-oxaliplatin–based adjuvant chemotherapy, whereas pT category, signet ring cell histology and cribriform comedo histology remained independent prognostic factors in patients receiving oxaliplatin-based adjuvant chemotherapy. Conclusions: pT4 status is the most significant pathologic determinant of poor outcome after fluoropyrimidine-based adjuvant chemotherapy in patients with stage II/III MSI-H CRC.
Image-Guided Fine Needle Cytology with Aspiration Versus Non-Aspiration in Retroperitoneal Masses: Is Aspiration Necessary?
Rajiv Kumar Misra, Shaila Mitra, Rishav Kumar Jain, Shilpa Vahikar, Archana Bundela, Purak Misra
J Pathol Transl Med. 2015;49(2):129-135.   Published online March 12, 2015
DOI: https://doi.org/10.4132/jptm.2015.01.28
  • 6,706 View
  • 60 Download
  • 6 Citations
AbstractAbstract PDF
Background
Although using fine needle cytology with aspiration (FNC-A) for establishing diagnoses in the retroperitoneal region has shown promise, there is scant literature supporting a role of non-aspiration cytology (FNC-NA) for this region. We assessed the accuracy and reliability of FNC-A and FNC-NA as tools for preoperative diagnosis of retroperitoneal masses and compared the results of both techniques with each other and with histopathology. Methods: Fifty-seven patients with retroperitoneal masses were subjected to FNC-A and FNC-NA. Smears were stained with May-Grunwald Giemsa and hematoxylin and eosin stain. An individual slide was objectively analysed using a point scoring system to enable comparison between FNC-A and FNC-NA. Results: By FNC-A, 91.7% accuracy was obtained in cases of retroperitoneal lymph node lesions followed by renal masses (83.3%). The diagnostic accuracy of other sites by FNC-A varied from 75.0%–81.9%. By FNC-NA, 93.4% diagnostically accurate results were obtained in the kidney, followed by 75.0% in adrenal masses. The diagnostic accuracy of other sites by FNC-NA varied from 66.7%–72.8%. Conclusions: Although both techniques have their own advantages and disadvantages, FNC-NA may be a more efficient adjuvant method of sampling in retroperitoneal lesions.
Accuracy of Core Needle Biopsy Versus Fine Needle Aspiration Cytology for Diagnosing Salivary Gland Tumors
In Hye Song, Joon Seon Song, Chang Ohk Sung, Jong-Lyel Roh, Seung-Ho Choi, Soon Yuhl Nam, Sang Yoon Kim, Jeong Hyun Lee, Jung Hwan Baek, Kyung-Ja Cho
J Pathol Transl Med. 2015;49(2):136-143.   Published online March 12, 2015
DOI: https://doi.org/10.4132/jptm.2015.01.03
  • 9,206 View
  • 169 Download
  • 52 Citations
AbstractAbstract PDF
Background
Core needle biopsy is a relatively new technique used to diagnose salivary gland lesions, and its role in comparison with fine needle aspiration cytology needs to be refined. Methods: We compared the results of 228 ultrasound-guided core needle biopsy and 371 fine needle aspiration procedures performed on major salivary gland tumors with their postoperative histological diagnoses. Results: Core needle biopsy resulted in significantly higher sensitivity and more accurate tumor subtyping, especially for malignant tumors, than fine needle aspiration. No patient developed major complications after core needle biopsy. Conclusions: We recommend ultrasoundguided core needle biopsy as the primary diagnostic tool for the preoperative evaluation of patients with salivary gland lesions, especially when malignancy is suspected.
Case Studies
Oncocytic Lipoadenoma: A Rare Case of Parotid Gland Tumor and Review of the Literature
Chen-lin Chi, Tseng-tong Kuo, Li-yu Lee
J Pathol Transl Med. 2015;49(2):144-147.   Published online March 12, 2015
DOI: https://doi.org/10.4132/jptm.2014.02.10
  • 7,484 View
  • 53 Download
  • 6 Citations
AbstractAbstract PDF
Oncocytic lipoadenoma is a rare tumor, with only 18 cases having been reported since the first in 1998. We encountered a case of oncocytic lipoadenoma presenting as a slowly growing parotid mass in a 71-year-old man. This tumor is characteristically comprised of a mixture of oncocytes and adipocytes. The present case is one of five reported cases of oncocytic lipoadenoma showing sebaceous differentiation. The results of immunohistochemical study with DOG1 antibody supported the origination of this tumor in the striated duct.
Fallopian Metaplastic Papillary Tumour: An Atypical Transdifferentiation of the Tubal Epithelium?
Miguel Fdo. Salazar, Isaías Estrada Moscoso, Lorena Troncoso Vázquez, Nubia Leticia López García, Paola Andrea Escalante Abril
J Pathol Transl Med. 2015;49(2):148-155.   Published online March 12, 2015
DOI: https://doi.org/10.4132/jptm.2014.10.15
  • 7,516 View
  • 53 Download
  • 2 Citations
AbstractAbstract PDF
A metaplastic papillary tumor of the Fallopian tube is an extremely uncommon condition, with odd and confusing features that make it difficult to categorize as benign or borderline. Here, we summarize all the published cases to date and document the case of a 41-year-old woman diagnosed with this alteration after her last childbirth and ensuing tubal ligation. One of the tubes was bulky and filled with a caramel-like substance encircling a blurry spot. Light microscopy detailed a slender stalk covered by eosinophilic, columnar plump cells, showing atypical nuclei and focal budding. Mitotic figures were absent. The immunohistochemistry panel was positive for pan-cytokeratin, epithelial membrane antigen, cyclin D1, and hormone receptors. Additionally, a proliferation index of less than 5% was rated using Ki-67. The true nature of this tumor (reactive vs neoplastic) is uncertain. Nonetheless, its association with pregnancy suggests an adaptive change, likely similar to the atypical transdifferentiation proposed for Arias-Stella reaction.
Brief Case Reports
Angiomyomatous Hamartoma of Popliteal Lymph Node: An Unusual Entity
Asit Ranjan Mridha, Richa Ranjan, Prateek Kinra, Ruma Ray, Shah Alam Khan, Gamanagatti Shivanand
J Pathol Transl Med. 2015;49(2):156-158.   Published online March 12, 2015
DOI: https://doi.org/10.4132/jptm.2013.08.08
  • 9,551 View
  • 67 Download
  • 5 Citations
PDF
Focal Hematopoietic Hyperplasia of Rib: A Rare Pseudotumor and Review of Literature
Maneesh Vijay, Asit Ranjan Mridha, Ruma Ray, Prateek Kinra, Biplab Mishra, H. S. Chandrashekhar
J Pathol Transl Med. 2015;49(2):159-162.   Published online March 12, 2015
DOI: https://doi.org/10.4132/jptm.2013.10.02
  • 7,959 View
  • 56 Download
  • 3 Citations
PDF
Serous Cystadenoma and Fibrothecoma: A Rare Combination in Collision Tumor of Ovary with Pseudo-Meigs Syndrome
Shirish S. Chandanwale, Sukanya S. Pal, Harsh B. Kumar, Amit B. Sammi
J Pathol Transl Med. 2015;49(2):163-166.   Published online March 12, 2015
DOI: https://doi.org/10.4132/jptm.2013.11.25
  • 8,774 View
  • 63 Download
  • 5 Citations
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Unicystic Granulosa Cell Tumor
Nalli R. Sumitra Devi, Sathya Lakshmi Ramu, Arun Prabhakaran, Deepa Devi Govindaswamy
J Pathol Transl Med. 2015;49(2):167-170.   Published online March 12, 2015
DOI: https://doi.org/10.4132/jptm.2014.04.02
  • 7,489 View
  • 60 Download
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Retiform Hemangioendothelioma of the Neck
Chin-Lung Kuo, Paul Chih-Hsueh Chen, Wing-Yin Li, Pen-Yuan Chu
J Pathol Transl Med. 2015;49(2):171-173.   Published online March 12, 2015
DOI: https://doi.org/10.4132/jptm.2013.10.14
  • 10,522 View
  • 67 Download
  • 1 Citations
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Metastatic Endobronchial Adenocarcinoma from the Uterine Cervix Verified by Human Papillomavirus Genotyping
Jisup Kim, Sungsoo Lee, Heae Surng Park
J Pathol Transl Med. 2015;49(2):174-176.   Published online March 12, 2015
DOI: https://doi.org/10.4132/jptm.2015.02.10
  • 8,438 View
  • 50 Download
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JPTM : Journal of Pathology and Translational Medicine