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Volume 49(6); November 2015
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Editorial
In Memory of Professor Je Geun Chi, a Great Mentor and Pathologist
Chong Jai Kim
J Pathol Transl Med. 2015;49(6):425-426.   Published online November 15, 2015
DOI: https://doi.org/10.4132/jptm.2015.10.06
  • 5,344 View
  • 42 Download
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Reviews
The Continuing Value of Ultrastructural Observation in Central Nervous System Neoplasms in Children
Na Rae Kim, Sung-Hye Park
J Pathol Transl Med. 2015;49(6):427-437.   Published online October 13, 2015
DOI: https://doi.org/10.4132/jptm.2015.09.19
  • 7,042 View
  • 54 Download
AbstractAbstract PDF
Central nervous system (CNS) neoplasms are the second most common childhood malignancy after leukemia and the most common solid organ neoplasm in children. Diagnostic dilemmas with small specimens from CNS neoplasms are often the result of multifactorial etiologies such as frozen or fixation artifact, biopsy size, or lack of knowledge about rare or unfamiliar entities. Since the late 1950s, ultrastructural examination has been used in the diagnosis of CNS neoplasms, though it has largely been replaced by immunohistochemical and molecular cytogenetic studies. Nowadays, pathologic diagnosis of CNS neoplasms is achieved through intraoperative cytology, light microscopy, immunohistochemistry, and molecular cytogenetic results. However, the utility of electron microscopy (EM) in the final diagnosis of CNS neoplasms and investigation of its pathogenetic origin remains critical. Here, we reviewed the distinguishing ultrastructural features of pediatric CNS neoplasms and emphasize the continuing value of EM in the diagnosis of CNS neoplasms.
Dysembryoplastic Neuroepithelial Tumors
Yeon-Lim Suh
J Pathol Transl Med. 2015;49(6):438-449.   Published online October 23, 2015
DOI: https://doi.org/10.4132/jptm.2015.10.05
  • 10,092 View
  • 220 Download
  • 15 Citations
AbstractAbstract PDF
Dysembryoplastic neuroepithelial tumor (DNT) is a benign glioneuronal neoplasm that most commonly occurs in children and young adults and may present with medically intractable, chronic seizures. Radiologically, this tumor is characterized by a cortical topography and lack of mass effect or perilesional edema. Partial complex seizures are the most common presentation. Three histologic subtypes of DNTs have been described. Histologically, the recognition of a unique, specific glioneuronal element in brain tumor samples from patients with medically intractable, chronic epilepsy serves as a diagnostic feature for complex or simple DNT types. However, nonspecific DNT has diagnostic difficulty because its histology is indistinguishable from conventional gliomas and because a specific glioneuronal element and/or multinodularity are absent. This review will focus on the clinical, radiographic, histopathological, and immunohistochemical features as well as the molecular genetics of all three variants of DNTs. The histological and cytological differential diagnoses for this lesion, especially the nonspecific variant, will be discussed.
Neuroendocrine Tumors of the Female Reproductive Tract: A Literature Review
Yi Kyeong Chun
J Pathol Transl Med. 2015;49(6):450-461.   Published online October 13, 2015
DOI: https://doi.org/10.4132/jptm.2015.09.20
  • 11,600 View
  • 152 Download
  • 13 Citations
AbstractAbstract PDF
Neuroendocrine tumors of the female reproductive tract are a heterogeneous group of neoplasms that display various histologic findings and biologic behaviors. In this review, the classification and clinicopathologic characteristics of neuroendocrine tumors of the female reproductive tract are described. Differential diagnoses are discussed, especially for non-neuroendocrine tumors showing high-grade nuclei with neuroendocrine differentiation. This review also discusses recent advances in our pathogenetic understanding of these disorders.
Acute Atherosis of the Uterine Spiral Arteries: Clinicopathologic Implications
Joo-Yeon Kim, Yeon Mee Kim
J Pathol Transl Med. 2015;49(6):462-471.   Published online November 4, 2015
DOI: https://doi.org/10.4132/jptm.2015.10.23
  • 13,458 View
  • 182 Download
  • 25 Citations
AbstractAbstract PDF
Acute atherosis is unique vascular changes of the placenta associated with poor placentation. It is characterized by subendothelial lipid-filled foam cells, fibrinoid necrosis of the arterial wall, perivascular lymphocytic infiltration, and it is histologically similar to early-stage atherosclerosis. Acute atherosis is rare in normal pregnancies, but is frequently observed in non- transformed spiral arteries in abnormal pregnancies, such as preeclampsia, small for gestational age (SGA), fetal death, spontaneous preterm labor and preterm premature rupture of membranes. In preeclampsia, spiral arteries fail to develop physiologic transformation and retain thick walls and a narrow lumen. Failure of physiologic transformation of spiral arteries is believed to be the main cause of uteroplacental ischemia, which can lead to the production of anti-angiogenic factors and induce endothelial dysfunction and eventually predispose the pregnancy to preeclampsia. Acute atherosis is more frequently observed in the spiral arteries of the decidua of the placenta (parietalis or basalis) than in the decidual or myometrial segments of the placental bed. The presence and deeper location of acute atherosis is associated with poorer pregnancy outcomes, more severe disease, earlier onset of preeclampsia, and a greater frequency of SGA neonates in patients with preeclampsia. Moreover, the idea that the presence of acute atherosis in the placenta may increase the risk of future cardiovascular disease in women with a history of preeclampsia is of growing concern. Therefore, placental examination is crucial for retrospective investigation of pregnancy complications and outcomes, and accurate placental pathology based on universal diagnostic criteria in patients with abnormal pregnancies is essential for clinicopathologic correlation.
Original Articles
Therapeutic Effects of Umbilical Cord Blood Derived Mesenchymal Stem Cell-Conditioned Medium on Pulmonary Arterial Hypertension in Rats
Jae Chul Lee, Choong Ik Cha, Dong-Sik Kim, Soo Young Choe
J Pathol Transl Med. 2015;49(6):472-480.   Published online October 16, 2015
DOI: https://doi.org/10.4132/jptm.2015.09.11
Retraction in: J Pathol Transl Med 2016;50(4):325
  • 12,149 View
  • 61 Download
  • 7 Citations
Analysis of Mutations in Epidermal Growth Factor Receptor Gene in Korean Patients with Non-small Cell Lung Cancer: Summary of a Nationwide Survey
Sang Hwa Lee, Wan Seop Kim, Yoo Duk Choi, Jeong Wook Seo, Joung Ho Han, Mi Jin Kim, Lucia Kim, Geon Kook Lee, Chang Hun Lee, Mee Hye Oh, Gou Young Kim, Sun Hee Sung, Kyo Young Lee, Sun Hee Chang, Mee Sook Rho, Han Kyeom Kim, Soon Hee Jung, Se Jin Jang, The Cardiopulmonary Pathology Study Group of Korean Society of Pathologists
J Pathol Transl Med. 2015;49(6):481-488.   Published online October 13, 2015
DOI: https://doi.org/10.4132/jptm.2015.09.14
  • 8,971 View
  • 84 Download
  • 17 Citations
AbstractAbstract PDF
Background
Analysis of mutations in the epidermal growth factor receptor gene (EGFR) is important for predicting response to EGFR tyrosine kinase inhibitors. The overall rate of EGFR mutations in Korean patients is variable. To obtain comprehensive data on the status of EGFR mutations in Korean patients with lung cancer, the Cardiopulmonary Pathology Study Group of the Korean Society of Pathologists initiated a nationwide survey. Methods: We obtained 1,753 reports on EGFR mutations in patients with lung cancer from 15 hospitals between January and December 2009. We compared EGFR mutations with patient age, sex, history of smoking, histologic diagnosis, specimen type, procurement site, tumor cell dissection, and laboratory status. Results: The overall EGFR mutation rate was 34.3% in patients with non-small cell lung cancer (NSCLC) and 43.3% in patients with adenocarcinoma. EGFR mutation rate was significantly higher in women, never smokers, patients with adenocarcinoma, and patients who had undergone excisional biopsy. EGFR mutation rates did not differ with respect to patient age or procurement site among patients with NSCLC. Conclusions: EGFR mutation rates and statuses were similar to those in published data from other East Asian countries.
Chronic Placental Inflammation in Twin Pregnancies
Heejin Bang, Go Eun Bae, Ha Young Park, Yeon Mee Kim, Suk-Joo Choi, Soo-young Oh, Cheong-Rae Roh, Jung-Sun Kim
J Pathol Transl Med. 2015;49(6):489-496.   Published online October 13, 2015
DOI: https://doi.org/10.4132/jptm.2015.09.09
  • 8,066 View
  • 68 Download
  • 7 Citations
AbstractAbstract PDF
Background
Chronic placental inflammation, such as villitis of unknown etiology (VUE) and chronic chorioamnionitis (CCA), is considered a placental manifestation of maternal anti-fetal rejection. The aim of this study is to investigate its frequency in twin pregnancies compared to singleton pregnancies. Methods: Three hundred twin placentas and 1,270 singleton placentas were consecutively collected at a tertiary medical center in Seoul, Republic of Korea from 2009 to 2012. Hematoxylin and eosin sections of tissue samples (full-thickness placental disc and chorioamniotic membranes) were reviewed. Results: Non-basal VUE was more frequent in twin placentas than in singleton placentas (6.0% vs 3.2%, p < .05). In preterm birth, CCA was found less frequently in twin placentas than in singleton placentas (9.6% vs 14.8%, p < .05), reaching its peak at an earlier gestational age in twin placentas (29–32 weeks) than in singleton placentas (33–36 weeks). CCA was more frequent in twin pregnancies with babies of a different sex than with those with the same sex (13.8% vs 6.9%, p = .052). Separate dichorionic diamniotic twin placentas were affected by chronic deciduitis more frequently than singleton placentas (16.9% vs 9.7%, p < .05). Conclusions: The higher frequency of non-basal VUE in twin placentas and of CCA in twin placentas with different fetal sex supports the hypothesis that the underlying pathophysiological mechanism is maternal anti-fetal rejection related to increased fetal antigens in twin pregnancies. The peak of CCA at an earlier gestational age in twin placentas than in singleton placentas suggests that CCA is influenced by placental maturation.
Tongue Growth during Prenatal Development in Korean Fetuses and Embryos
Soo Jeong Hong, Bong Geun Cha, Yeon Sook Kim, Suk Keun Lee, Je Geun Chi
J Pathol Transl Med. 2015;49(6):497-510.   Published online October 16, 2015
DOI: https://doi.org/10.4132/jptm.2015.09.17
  • 9,416 View
  • 97 Download
  • 8 Citations
AbstractAbstract PDF
Background
Prenatal tongue development may affect oral-craniofacial structures, but this muscular organ has rarely been investigated. Methods: In order to document the physiology of prenatal tongue growth, we histologically examined the facial and cranial base structures of 56 embryos and 106 fetuses. Results: In Streeter’s stages 13–14 (fertilization age [FA], 28 to 32 days), the tongue protruded into the stomodeal cavity from the retrohyoid space to the cartilaginous mesenchyme of the primitive cranial base, and in Streeter’s stage 15 (FA, 33 to 36 days), the tongue rapidly swelled and compressed the cranial base to initiate spheno-occipital synchondrosis and continued to swell laterally to occupy most of the stomodeal cavity in Streeter’s stage 16–17 (FA, 37 to 43 days). In Streeter’s stage 18–20 (FA, 44 to 51 days), the tongue was vertically positioned and filled the posterior nasopharyngeal space. As the growth of the mandible and maxilla advanced, the tongue was pulled down and protruded anteriorly to form the linguomandibular complex. Angulation between the anterior cranial base (ACB) and the posterior cranial base (PCB) was formed by the emerging tongue at FA 4 weeks and became constant at approximately 124°–126° from FA 6 weeks until birth, which was consistent with angulations measured on adult cephalograms. Conclusions: The early clockwise growth of the ACB to the maxillary plane became harmonious with the counter-clockwise growth of the PCB to the tongue axis during the early prenatal period. These observations suggest that human embryonic tongue growth affects ACB and PCB angulation, stimulates maxillary growth, and induces mandibular movement to achieve the essential functions of oral and maxillofacial structures.
Comprehensive Cytomorphologic Analysis of Pulmonary Adenoid Cystic Carcinoma: Comparison to Small Cell Carcinoma and Non-pulmonary Adenoid Cystic Carcinoma
Seokhwi Kim, Jinah Chu, Hojoong Kim, Joungho Han
J Pathol Transl Med. 2015;49(6):511-519.   Published online October 19, 2015
DOI: https://doi.org/10.4132/jptm.2015.09.07
  • 7,905 View
  • 53 Download
  • 2 Citations
AbstractAbstract PDF
Background
Cytologic diagnosis of pulmonary adenoid cystic carcinoma (AdCC) is frequently challenging and differential diagnosis with small cell carcinoma is often difficult. Methods: Eleven cytologically diagnosed cases of pulmonary AdCC were collected and reviewed according to fifteen cytomorphologic characteristics: small cell size, cellular uniformity, coarse chromatin, hyperchromasia, distinct nucleolus, frequent nuclear molding, granular cytoplasm, organoid cluster, sheet formation, irregular border of cluster, hyaline globule, hyaline basement membrane material, individual cell necrosis or apoptotic body, and necrotic background. Twenty cases of small cell carcinoma and fifteen cases of non-pulmonary AdCC were also reviewed for the comparison. Results: Statistically significant differences were identified between pulmonary AdCC and small cell carcinoma in fourteen of the fifteen cytomorphologic criteria (differences in sheet formation were not statistically significant). Cellular uniformity, distinct nucleolus, granular cytoplasm, distinct cell border, organoid cluster, hyaline globule, and hyaline basement membrane material were characteristic features of AdCC. Frequent nuclear molding, individual cell necrosis, and necrotic background were almost exclusively identified in small cell carcinoma. Although coarse chromatin and irregular cluster border were observed in both, they favored the diagnosis of small cell carcinoma. Hyaline globules were more frequently seen in non-pulmonary AdCC cases. Conclusions: Using the fifteen cytomorphologic criteria described by this study, pulmonary AdCC could be successfully distinguished from small cell carcinoma. Such a comprehensive approach to an individual case is recommended for the cytologic diagnosis of pulmonary AdCC.
Case Studies
Mediastinal Glomus Tumor: A Case Report and Literature Review
Si-Hyong Jang, Hyun Deuk Cho, Ji-Hye Lee, Hyun Ju Lee, Hae Yoen Jung, Kyung-Ju Kim, Sung Sik Cho, Mee-Hye Oh
J Pathol Transl Med. 2015;49(6):520-524.   Published online August 4, 2015
DOI: https://doi.org/10.4132/jptm.2015.07.02
  • 8,550 View
  • 55 Download
  • 8 Citations
AbstractAbstract PDF
A glomus tumor in the mediastinum is very uncommon, and only five cases have been reported in the English literature. We recently encountered a 21-year-old woman with an asymptomatic mediastinal mass that measured 5.3 × 4.0 cm. Surgical excision was performed, and the tumor was finally diagnosed as mediastinal glomus tumor with an uncertain malignant potential. After reviewing this case and previous reports, we analyzed the clinicopathologic features associated with progression of such a tumor.
CD30-Positive T-Cell Lymphoproliferative Disease of the Oral Mucosa in Children: A Manifestation of Epstein-Barr Virus-Associated T-Lymphoproliferative Disorder
Mineui Hong, Young Hyeh Ko
J Pathol Transl Med. 2015;49(6):525-530.   Published online September 30, 2015
DOI: https://doi.org/10.4132/jptm.2015.07.13
  • 8,366 View
  • 79 Download
  • 1 Citations
AbstractAbstract PDF
Eosinophilic ulcer of the oral mucosa (EUOM) is a very rare, benign, self-limiting ulcerative lesion of the oral cavity of unknown pathogenesis, and belongs to the same spectrum of CD30+ T-cell lymphoproliferative disease (LPD) of the oral mucosa. The etiology and pathogenesis of the disease are unknown. We report two cases in children who were initially diagnosed with EUOM and CD30+ T-cell LPD, respectively. However, retrospective analysis revealed that a majority of infiltrated atypical T cells were positive for Epstein-Barr virus (EBV). The present cases suggest that the pathogenesis and etiology of EUOM or CD30+ T-cell LPD occurring in children are different from those in adults. EUOM or CD30+ T-cell LPD in children is a manifestation of EBV-positive T-cell LPD, and should therefore be distinguished from the disease in adults.
Brief Case Reports
Intrahepatic Cholangiocarcinoma with Ductal Plate Malformation-like Feature Associated with Bile Duct Adenoma
Ah-Young Kwon, Hye Jin Lee, Hee Jung An, Haeyoun Kang, Jin-Hyung Heo, Gwangil Kim
J Pathol Transl Med. 2015;49(6):531-534.   Published online July 31, 2015
DOI: https://doi.org/10.4132/jptm.2015.06.19
  • 8,624 View
  • 95 Download
  • 2 Citations
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Apocrine Carcinoma of the Axilla Associated with Extramammary Paget’s Disease: A Case Report and Review of the Literature
Hye Ra Jung, Sun Young Kwon, Daegu Son
J Pathol Transl Med. 2015;49(6):535-537.   Published online September 17, 2015
DOI: https://doi.org/10.4132/jptm.2015.06.22
  • 7,693 View
  • 47 Download
  • 4 Citations
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Correspondence
Erratum: 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(6):538-538.   Published online November 15, 2015
DOI: https://doi.org/10.4132/jptm.2015.05.20.r
Corrects: J Pathol Transl Med 2015;49(4):325
  • 4,964 View
  • 50 Download
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JPTM : Journal of Pathology and Translational Medicine