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Volume 49(4); July 2015
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Reviews
A Review of Inflammatory Processes of the Breast with a Focus on Diagnosis in Core Biopsy Samples
Timothy M. D’Alfonso, Paula S. Ginter, Sandra J. Shin
J Pathol Transl Med. 2015;49(4):279-287.   Published online June 22, 2015
DOI: https://doi.org/10.4132/jptm.2015.06.11
  • 18,896 View
  • 352 Download
  • 27 Citations
AbstractAbstract PDF
Inflammatory and reactive lesions of the breast are relatively uncommon among benign breast lesions and can be the source of an abnormality on imaging. Such lesions can simulate a malignant process, based on both clinical and radiographic findings, and core biopsy is often performed to rule out malignancy. Furthermore, some inflammatory processes can mimic carcinoma or other malignancy microscopically, and vice versa. Diagnostic difficulty may arise due to the small and fragmented sample of a core biopsy. This review will focus on the pertinent clinical, radiographic, and histopathologic features of the more commonly encountered inflammatory lesions of the breast that can be characterized in a core biopsy sample. These include fat necrosis, mammary duct ectasia, granulomatous lobular mastitis, diabetic mastopathy, and abscess. The microscopic differential diagnoses for these lesions when seen in a core biopsy sample will be discussed.
Pathology Reporting of Thyroid Core Needle Biopsy: A Proposal of the Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Group
Chan Kwon Jung, Hye Sook Min, Hyo Jin Park, Dong Eun Song, Jang Hee Kim, So Yeon Park, Hyunju Yoo, Mi Kyung Shin, Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Group
J Pathol Transl Med. 2015;49(4):288-299.   Published online June 17, 2015
DOI: https://doi.org/10.4132/jptm.2015.06.04
  • 14,360 View
  • 310 Download
  • 86 Citations
AbstractAbstract PDF
In recent years throughout Korea, the use of ultrasound-guided core needle biopsy (CNB) has become common for the preoperative diagnosis of thyroid nodules. However, there is no consensus on the pathology reporting system for thyroid CNB. The Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Group held a conference on thyroid CNB pathology and developed guidelines through contributions from the participants. This article discusses the outcome of the discussions that led to a consensus on the pathology reporting of thyroid CNB.
The Utilization of Cytologic Fine-Needle Aspirates of Lung Cancer for Molecular Diagnostic Testing
Michael H. Roh
J Pathol Transl Med. 2015;49(4):300-309.   Published online June 16, 2015
DOI: https://doi.org/10.4132/jptm.2015.06.16
  • 11,923 View
  • 140 Download
  • 28 Citations
AbstractAbstract PDF
In this era of precision medicine, our understanding and knowledge of the molecular landscape associated with lung cancer pathogenesis continues to evolve. This information is being increasingly exploited to treat advanced stage lung cancer patients with tailored, targeted therapy. During the management of these patients, minimally invasive procedures to obtain samples for tissue diagnoses are desirable. Cytologic fine-needle aspirates are often utilized for this purpose and are important not only for rendering diagnoses to subtype patients’ lung cancers, but also for ascertaining molecular diagnostic information for treatment purposes. Thus, cytologic fine-needle aspirates must be utilized and triaged judiciously to achieve both objectives. In this review, strategies in utilizing fine-needle aspirates will be discussed in the context of our current understanding of the clinically actionable molecular aberrations underlying non-small cell lung cancer and the molecular assays applied to these samples in order to obtain treatment-relevant molecular diagnostic information.
Original Articles
Analysis of Histologic Features Suspecting Anaplastic Lymphoma Kinase (ALK)-Expressing Pulmonary Adenocarcinoma
In Ho Choi, Dong Won Kim, Sang Yun Ha, Yoon-La Choi, Hee Jeong Lee, Joungho Han
J Pathol Transl Med. 2015;49(4):310-317.   Published online June 22, 2015
DOI: https://doi.org/10.4132/jptm.2015.05.13
  • 8,424 View
  • 85 Download
  • 16 Citations
AbstractAbstract PDF
Background
Since 2007 when anaplastic lymphoma kinase (ALK) rearrangements were discovered in non-small cell lung cancer, the ALK gene has received attention due to ALK-targeted therapy, and a notable treatment advantage has been observed in patients harboring the EML4/ALK translocation. However, using ALK-fluorescence in situ hybridization (FISH) as the standard method has demerits such as high cost, a time-consuming process, dependency on interpretation skill, and tissue preparation. We analyzed the histologic findings which could complement the limitation of ALK-FISH test for pulmonary adenocarcinoma. Methods: Two hundred five cases of ALK-positive and 101 of ALK-negative pulmonary adenocarcinoma from January 2007 to May 2013 were enrolled in this study. The histologic findings and ALK immunohistochemistry results were reviewed and compared with the results of ALK-FISH and EGFR/KRAS mutation status. Results: Acinar, cribriform, and solid growth patterns, extracellular and intracellular mucin production, and presence of signet-ring-cell element, and psammoma body were significantly more often present in ALK-positive cancer. In addition, the presence of goblet cell-like cells and presence of nuclear inclusion and groove resembling papillary thyroid carcinoma were common in the ALK-positive group. Conclusions: The above histologic parameters can be helpful in predicting ALK rearranged pulmonary adenocarcinoma, leading to rapid FISH analysis and timely treatment.
Cancers with Higher Density of Tumor-Associated Macrophages Were Associated with Poor Survival Rates
Kyong Yeun Jung, Sun Wook Cho, Young A Kim, Daein Kim, Byung-Chul Oh, Do Joon Park, Young Joo Park
J Pathol Transl Med. 2015;49(4):318-324.   Published online June 17, 2015
DOI: https://doi.org/10.4132/jptm.2015.06.01
  • 9,865 View
  • 189 Download
  • 88 Citations
AbstractAbstract PDF
Background
Macrophages are a component of a tumor’s microenvironment and have various roles in tumor progression and metastasis. This study evaluated the relationships between tumor-associated macrophage (TAM) density and clinical outcomes in 14 different types of human cancers. Methods: We investigated TAM density in human tissue microarray sections from 14 different types of human cancers (n = 266) and normal thyroid, lung, and breast tissues (n = 22). The five-year survival rates of each cancer were obtained from the 2011 Korea Central Cancer Registry. Results: Among 13 human cancers, excluding thyroid cancer, pancreas, lung, and gallbladder cancers had the highest density of CD163-positive macrophages (7.0±3.5%, 6.9±7.4%, and 6.9 ± 5.5%, respectively). The five-year relative survival rates of these cancers (pancreas, 8.7%; lung, 20.7%; gallbladder, 27.5%) were lower than those of other cancers. The histological subtypes in thyroid cancer exhibited significantly different CD163-positive macrophages densities (papillary, 1.8 ± 1.6% vs anaplastic, 22.9 ± 17.1%; p < .001), but no significant difference between histological subtypes was detected in lung and breast cancers. Moreover, there was no significant difference in CD163-positive macrophages densities among the TNM stages in lung, breast, and thyroid cancers. Conclusions: Cancers with higher TAM densities (pancreas, lung, anaplastic thyroid, and gallbladder) were associated with poor survival rate.
Case Studies
WHO Grade IV Gliofibroma: A Grading Label Denoting Malignancy for an Otherwise Commonly Misinterpreted Neoplasm
Paola A. Escalante Abril, Miguel Fdo. Salazar, Nubia L. López García, Mónica N. Madrazo Moya, Yadir U. Zamora Guerra, Yadira Gandhi Mata Mendoza, Erick Gómez Apo, Laura G. Chávez Macías
J Pathol Transl Med. 2015;49(4):325-330.   Published online June 17, 2015
DOI: https://doi.org/10.4132/jptm.2015.05.20
Correction in: J Pathol Transl Med 2015;49(6):538
  • 7,410 View
  • 68 Download
  • 1 Citations
AbstractAbstract PDF
We report a 50-year-old woman with no relevant clinical history who presented with headache and loss of memory. Magnetic resonance imaging showed a left parieto-temporal mass with annular enhancement after contrast media administration, rendering a radiological diagnosis of high-grade astrocytic neoplasm. Tumour sampling was performed but the patient ultimately died as a result of disease. Microscopically, the lesion had areas of glioblastoma mixed with a benign mesenchymal constituent; the former showed hypercellularity, endothelial proliferation, high mitotic activity and necrosis, while the latter showed fascicles of long spindle cells surrounded by collagen and reticulin fibers. With approximately 40 previously reported cases, gliofibroma is a rare neoplasm defined as either glio-desmoplastic or glial/benign mesenchymal. As shown in our case, its prognosis is apparently determined by the degree of anaplasia of the glial component.
A Rare Case of Primary Tubular Adenocarcinoma of the Thymus, Enteric Immunophenotype: A Case Study and Review of the Literature
Hae Yoen Jung, Hyundeuk Cho, Jin-Haeng Chung, Sang Byoung Bae, Ji-Hye Lee, Hyun Ju Lee, Si-Hyong Jang, Mee-Hye Oh
J Pathol Transl Med. 2015;49(4):331-334.   Published online June 1, 2015
DOI: https://doi.org/10.4132/jptm.2015.04.16
  • 7,756 View
  • 67 Download
  • 10 Citations
AbstractAbstract PDF
Thymic carcinomas are uncommon malignant tumors, and thymic adenocarcinomas are extremely rare. Here, we describe a case of primary thymic adenocarcinoma in a 59-year-old woman. Histological examination of the tumor revealed tubular morphology with expression of cytokeratin 20 and caudal-type homeobox 2 according to immunohistochemistry, suggesting enteric features. Extensive clinical and radiological studies excluded the possibility of an extrathymic primary tumor. A review of the literature revealed only two global cases of primary tubular adenocarcinomas of the thymus with enteric immunophenotype.
Brief Case Reports
Sclerosing Extramedullary Hematopoietic Tumor Mimicking Intra-abdominal Sarcoma
Serap Karaarslan, Nalan Nese, Guray Oncel, Nazan Ozsan, Taner Akalin, Hasan Kaplan, Filiz Buyukkececi, Mine Hekimgil
J Pathol Transl Med. 2015;49(4):335-338.   Published online June 15, 2015
DOI: https://doi.org/10.4132/jptm.2015.04.22
  • 7,385 View
  • 55 Download
  • 2 Citations
PDF
Ureteral Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue, Chronic Inflammation, and Renal Artery Atherosclerosis
Hojung Lee, Jong Eun Joo, Young Ok Hong, Won Mi Lee, Eun Kyung Kim, Jeong Joo Woo, Soo Jung Gong, Jooryung Huh
J Pathol Transl Med. 2015;49(4):339-342.   Published online June 1, 2015
DOI: https://doi.org/10.4132/jptm.2015.04.28
  • 7,497 View
  • 60 Download
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Late Bone Metastasis of Histologically Bland Struma Ovarii: The Unpredictability of Its Biologic Behavior
Sun-Ju Oh, Minjung Jung, Young-Ok Kim
J Pathol Transl Med. 2015;49(4):343-345.   Published online June 15, 2015
DOI: https://doi.org/10.4132/jptm.2015.04.27
  • 6,582 View
  • 66 Download
  • 3 Citations
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Necrotizing Sarcoid Granulomatosis: Possibly Veiled Disease in Endemic Area of Mycobacterial Infection
Yosep Chong, Eun Jung Lee, Chang Suk Kang, Tae-Jung Kim, Jung Sup Song, Hyosup Shim
J Pathol Transl Med. 2015;49(4):346-350.   Published online June 1, 2015
DOI: https://doi.org/10.4132/jptm.2015.04.17
  • 6,479 View
  • 67 Download
  • 9 Citations
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Salivary Gland Hyalinizing Clear Cell Carcinoma
Jung-Chia Lin, Jia-Bin Liao, Hsiao-Ting Fu, Ting-Shou Chang, Jyh-Seng Wang
J Pathol Transl Med. 2015;49(4):351-353.   Published online June 16, 2015
DOI: https://doi.org/10.4132/jptm.2015.05.06
  • 6,972 View
  • 66 Download
  • 4 Citations
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JPTM : Journal of Pathology and Translational Medicine