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Volume 49(3); May 2015
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Reviews
Galectins: Double-edged Swords in the Cross-roads of Pregnancy Complications and Female Reproductive Tract Inflammation and Neoplasia
Nandor Gabor Than, Roberto Romero, Andrea Balogh, Eva Karpati, Salvatore Andrea Mastrolia, Orna Staretz-Chacham, Sinuhe Hahn, Offer Erez, Zoltan Papp, Chong Jai Kim
J Pathol Transl Med. 2015;49(3):181-208.   Published online May 15, 2015
DOI: https://doi.org/10.4132/jptm.2015.02.25
  • 23,514 View
  • 258 Download
  • 38 Citations
AbstractAbstract PDF
Galectins are an evolutionarily ancient and widely expressed family of lectins that have unique glycan-binding characteristics. They are pleiotropic regulators of key biological processes, such as cell growth, proliferation, differentiation, apoptosis, signal transduction, and pre-mRNA splicing, as well as homo- and heterotypic cell-cell and cell-extracellular matrix interactions. Galectins are also pivotal in immune responses since they regulate host-pathogen interactions, innate and adaptive immune responses, acute and chronic inflammation, and immune tolerance. Some galectins are also central to the regulation of angiogenesis, cell migration and invasion. Expression and functional data provide convincing evidence that, due to these functions, galectins play key roles in shared and unique pathways of normal embryonic and placental development as well as oncodevelopmental processes in tumorigenesis. Therefore, galectins may sometimes act as double-edged swords since they have beneficial but also harmful effects for the organism. Recent advances facilitate the use of galectins as biomarkers in obstetrical syndromes and in various malignancies, and their therapeutic applications are also under investigation. This review provides a general overview of galectins and a focused review of this lectin subfamily in the context of inflammation, infection and tumors of the female reproductive tract as well as in normal pregnancies and those complicated by the great obstetrical syndromes.
Advances in the Endoscopic Assessment of Inflammatory Bowel Diseases: Cooperation between Endoscopic and Pathologic Evaluations
Jae Hee Cheon
J Pathol Transl Med. 2015;49(3):209-217.   Published online May 15, 2015
DOI: https://doi.org/10.4132/jptm.2015.04.09
  • 10,593 View
  • 86 Download
  • 4 Citations
AbstractAbstract PDF
Endoscopic assessment has a crucial role in the management of inflammatory bowel disease (IBD). It is particularly useful for the assessment of IBD disease extension, severity, and neoplasia surveillance. Recent advances in endoscopic imaging techniques have been revolutionized over the past decades, progressing from conventional white light endoscopy to novel endoscopic techniques using molecular probes or electronic filter technologies. These new technologies allow for visualization of the mucosa in detail and monitor for inflammation/dysplasia at the cellular or sub-cellular level. These techniques may enable us to alter the IBD surveillance paradigm from four quadrant random biopsy to targeted biopsy and diagnosis. High definition endoscopy and dye-based chromoendoscopy can improve the detection rate of dysplasia and evaluate inflammatory changes with better visualization. Dye-less chromoendoscopy, including narrow band imaging, iScan, and autofluorescence imaging can also enhance surveillance in comparison to white light endoscopy with optical or electronic filter technologies. Moreover, confocal laser endomicroscopy or endocytoscopy have can achieve real-time histology evaluation in vivo and have greater accuracy in comparison with histology. These new technologies could be combined with standard endoscopy or further histologic confirmation in patients with IBD. This review offers an evidence-based overview of new endoscopic techniques in patients with IBD.
Pathology-MRI Correlation of Hepatocarcinogenesis: Recent Update
Jimi Huh, Kyung Won Kim, Jihun Kim, Eunsil Yu
J Pathol Transl Med. 2015;49(3):218-229.   Published online May 15, 2015
DOI: https://doi.org/10.4132/jptm.2015.04.15
  • 21,196 View
  • 268 Download
  • 6 Citations
AbstractAbstract PDF
Understanding the important alterations during hepatocarcinogenesis as well as the characteristic magnetic resonance imaging (MRI) and histopathological features will be helpful for managing patients with chronic liver disease and hepatocellular carcinoma. Recent advances in MRI techniques, such as fat/iron quantification, diffusion-weighted images, and gadoxetic acid-enhanced MRI, have greatly enhanced our understanding of hepatocarcinogenesis.
Effectiveness and Limitations of Core Needle Biopsy in the Diagnosis of Thyroid Nodules: Review of Current Literature
Jung Hyun Yoon, Eun-Kyung Kim, Jin Young Kwak, Hee Jung Moon
J Pathol Transl Med. 2015;49(3):230-235.   Published online May 15, 2015
DOI: https://doi.org/10.4132/jptm.2015.03.21
  • 9,268 View
  • 88 Download
  • 37 Citations
AbstractAbstract PDF
Fine needle aspiration (FNA) is currently accepted as an easy, safe, and reliable tool for the diagnosis of thyroid nodules. Nonetheless, a proportion of FNA samples are categorized into non-diagnostic or indeterminate cytology, which frustrates both the clinician and patient. To overcome this limitation of FNA, core needle biopsy (CNB) of the thyroid has been proposed as an additional diagnostic method for more accurate and decisive diagnosis for thyroid nodules of concern. In this review, we focus on the effectiveness and limitations of CNB, and what factors should be considered when CNB is utilized in the diagnosis of thyroid nodules.
Original Articles
Proposal of an Appropriate Decalcification Method of Bone Marrow Biopsy Specimens in the Era of Expanding Genetic Molecular Study
Sung-Eun Choi, Soon Won Hong, Sun Och Yoon
J Pathol Transl Med. 2015;49(3):236-242.   Published online May 15, 2015
DOI: https://doi.org/10.4132/jptm.2015.03.16
  • 10,747 View
  • 238 Download
  • 38 Citations
AbstractAbstract PDF
Background
The conventional method for decalcification of bone specimens uses hydrochloric acid (HCl) and is notorious for damaging cellular RNA, DNA, and proteins, thus complicating molecular and immunohistochemical analyses. A method that can effectively decalcify while preserving genetic material is necessary. Methods: Pairs of bilateral bone marrow biopsies sampled from 53 patients were decalcified according to protocols of two comparison groups: EDTA versus HCl and RDO GOLD (RDO) versus HCl. Pairs of right and left bone marrow biopsy samples harvested from 28 cases were allocated into the EDTA versus HCl comparison group, and 25 cases to the RDO versus HCl comparison group. The decalcification protocols were compared with regards to histomorphology, immunohistochemistry, and molecular analysis. For molecular analysis, we randomly selected 5 cases from the EDTA versus HCl and RDO versus HCl groups. Results: The decalcification time for appropriate histomorphologic analysis was the longest in the EDTA method and the shortest in the RDO method. EDTA was superior to RDO or HCl in DNA yield and integrity, assessed via DNA extraction, polymerase chain reaction, and silver in situ hybridization using DNA probes. The EDTA method maintained intact nuclear protein staining on immunohistochemistry, while the HCl method produced poor quality images. Staining after the RDO method had equivocal results. RNA in situ hybridization using kappa and lambda RNA probes measured RNA integrity; the EDTA and RDO method had the best quality, followed by HCl. Conclusions: The EDTA protocol would be the best in preserving genetic material. RDO may be an acceptable alternative when rapid decalcification is necessary.
Smad1 Expression in Follicular Lymphoma
Jai Hyang Go
J Pathol Transl Med. 2015;49(3):243-248.   Published online May 15, 2015
DOI: https://doi.org/10.4132/jptm.2015.03.30
  • 6,411 View
  • 42 Download
AbstractAbstract PDF
Background
Follicular lymphomas present with various immunohistologic patterns. The immunohistochemical markers used in the diagnosis of follicular lymphoma show variable degrees of sensitivity and specificity, and thus, additional germinal center markers are required. Smad1 has been reported to be overexpressed in follicular lymphoma, but little is known regarding the expression patterns of Smad proteins in human lymphoid tissue. Methods: In the present study, we performed immunohistochemistry for traditional germinal center markers and for Smad1 in human reactive lymphoid and follicular lymphoma tissues to investigate Smad1’s usefulness in the diagnosis of follicular lymphoma. Results: In the reactive germinal centers, most cells were positive for Smad1. Among the 27 follicular lymphoma cases, 17 of 21 (80%) were Smad1 positive, 17 of 27 (63%) were positive for CD10, and 23 of 27 (85%) were positive for Bcl6. Notably, three cases expressed CD10 only, and one only expressed Bcl6. All these cases were grade 3 tumors and showed follicular and diffuse growth patterns. Conclusions: These results indicate that Smad1 is a candidate as a germinal center marker. Furthermore, they suggest that the Smad signaling pathway might be involved in follicular lymphoma.
MUC2 Expression Is Correlated with Tumor Differentiation and Inhibits Tumor Invasion in Gastric Carcinomas: A Systematic Review and Meta-analysis
Jung-Soo Pyo, Jin Hee Sohn, Guhyun Kang, Dong-Hoon Kim, Kyungeun Kim, In-Gu Do, Dong Hyun Kim
J Pathol Transl Med. 2015;49(3):249-256.   Published online May 15, 2015
DOI: https://doi.org/10.4132/jptm.2015.03.27
  • 6,546 View
  • 61 Download
  • 4 Citations
AbstractAbstract PDF
Background
While MUC2 is expressed in intestinal metaplasia and malignant lesions, the clinico-pathological significance of MUC2 expression is not fully elucidated in gastric carcinoma (GC). Methods: The present study investigated the correlation between MUC2 expression and clinico-pathological parameters in 167 human GCs. In addition, to confirm the clinicopathological significance of MUC2 expression, we performed a systematic review and meta-analysis in 1,832 GCs. Results: MUC2 expression was found in 58 of 167 GCs (34.7%). MUC2-expressing GC showed lower primary tumor (T), regional lymph node (N), and tumor node metastasis (TNM) stages compared with GCs without MUC2 expression (p=.001, p=.001, and p=.011, respectively). However, MUC2 expression was not correlated with Lauren’s classification and tumor differentiation. In meta-analysis, MUC2 expression was significantly correlated with differentiation and lower tumor stage (odds ratio [OR], 1.303; 95% confidence interval [CI], 1.020 to 1.664; p = .034 and OR, 1.352; 95% CI, 1.055 to 1.734; p = .017, respectively) but not with Lauren’s classification, pN stage, or pTNM stage. Conclusions: MUC2 expression was correlated with a lower tumor depth and lower lymph node metastasis in our study; the meta-analysis showed a correlation of MUC2 expression with tumor differentiation and lower tumor depth.
IDH Mutation Analysis in Ewing Sarcoma Family Tumors
Ki Yong Na, Byeong-Joo Noh, Ji-Youn Sung, Youn Wha Kim, Eduardo Santini Araujo, Yong-Koo Park
J Pathol Transl Med. 2015;49(3):257-261.   Published online May 15, 2015
DOI: https://doi.org/10.4132/jptm.2015.04.14
  • 8,433 View
  • 69 Download
  • 5 Citations
AbstractAbstract PDF
Background
Isocitrate dehydrogenase (IDH) catalyzes the oxidative decarboxylation of isocitrate to yield α-ketoglutarate (α-KG) with production of reduced nicotinamide adenine dinucleotide (NADH). Dysfunctional IDH leads to reduced production of α-KG and NADH and increased production of 2-hydroxyglutarate, an oncometabolite. This results in increased oxidative damage and stabilization of hypoxia-inducible factor α, causing cells to be prone to tumorigenesis. Methods: This study investigated IDH mutations in 61 Ewing sarcoma family tumors (ESFTs), using a pentose nucleic acid clamping method and direct sequencing. Results: We identified four cases of ESFTs harboring IDH mutations. The number of IDH1 and IDH2 mutations was equal and the subtype of IDH mutations was variable. Clinicopathologic analysis according to IDH mutation status did not reveal significant results. Conclusions: This study is the first to report IDH mutations in ESFTs. The results indicate that ESFTs can harbor IDH mutations in previously known hot-spot regions, although their incidence is rare. Further validation with a larger case-based study would establish more reliable and significant data on prevalence rate and the biological significance of IDH mutations in ESFTs.
Case Study
Follicular Proliferative Lesion Arising in Struma Ovarii
Min Jee Park, Min A Kim, Mi Kyung Shin, Hye Sook Min
J Pathol Transl Med. 2015;49(3):262-266.   Published online May 15, 2015
DOI: https://doi.org/10.4132/jptm.2015.03.26
  • 7,153 View
  • 116 Download
  • 5 Citations
AbstractAbstract PDF
Malignant struma ovarii is extremely rare and difficult to diagnose histologically, particularly in cases of follicular carcinoma. This case study is intended to describe three cases of follicular proliferative lesion arising in struma ovarii that we experienced. The first case was clearly malignant given the clinical picture of multiple recurrences, but there was little histological evidence of malignancy. Our second case featured architectural and cellular atypia and necrosis and was diagnosed as malignant despite the absence of vascular and stromal invasion. Our third case exhibit-ed solid microfollicular proliferation without any definite evidence of malignancy (even the molecular data was negative); however, we could not completely exclude malignant potential after conducting a literature review. In cases such as our third case, it has been previously suggested that a diagnostic term recognizing the low-grade malignant potential, such as “proliferative stromal ovarii” or “follicular proliferative lesion arising in the stromal ovarii” would be appropriate.
Brief Case Reports
Traumatic Bowel Perforation and Inguinal Hernia Masking a Mesenteric Calcifying Fibrous Tumor
Dong Hyun Kim, Kyueng-Whan Min, Dong-Hoon Kim, Seoung Wan Chae, Jin Hee Sohn, Jung-Soo Pyo, Sung-Im Do, Kyungeun Kim, Hyun Joo Lee
J Pathol Transl Med. 2015;49(3):267-269.   Published online May 15, 2015
DOI: https://doi.org/10.4132/jptm.2015.03.20
  • 6,380 View
  • 44 Download
  • 1 Citations
PDF
Cytomegalovirus-Associated Intussusception with Florid Vascular Proliferation in an Infant
Heejung Park, Sanghui Park, Young Ju Hong, Sun Wha Lee, Min-Sun Cho
J Pathol Transl Med. 2015;49(3):270-273.   Published online May 15, 2015
DOI: https://doi.org/10.4132/jptm.2015.04.01
  • 5,998 View
  • 39 Download
  • 3 Citations
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A Case of Primary Subpleural Pulmonary Microcystic Myxoma Coincidentally Occurred with Pulmonary Adenocarcinoma
Jungsuk Ahn, Na Rae Kim, Seung Yeon Ha, Keun-Woo Kim, Kook Yang Park, Yon Mi Sung
J Pathol Transl Med. 2015;49(3):274-278.   Published online May 15, 2015
DOI: https://doi.org/10.4132/jptm.2015.03.12
  • 6,188 View
  • 48 Download
  • 1 Citations
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JPTM : Journal of Pathology and Translational Medicine