Journal of Pathology and Translational Medicine

Volume 5(2); December 1994

Original Articles

Clinical and Histopathological Studies on Surgical Breast Diseases among Koreans: Jae Yun Ro, Yoo Bock Lee, Dong Sik Kim; Korean J Cytopathol. 1971;5(2):77-98.

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Abstract PDF: Lesions of the breast are preponderantly confined to the female. In the male and female prior to puberty the breast is a rudimentary structure relatively insensitive to endocrine influence, such as ovarian, pituitary and adrenal hormones and apparently and adrenal hormones and apparently to neoplastic growth. In the female after puberty, on the other hand, the more complex breast structure, the greater breast volume and the extreme sensitivity to endocrine influences all predisposed this organ to a number of pathologic conditions. To an almost exclusive degree, then, the woman who today presents herself with a dominant complaint related to the mammary glands will prove to be diagnosable as one of the "big three" : (1) dysplasia, (2) benign neoplasia, most often fibroadenoma, or (3) malignant neoplasia, most often carcinoma. The many Patterns of breast Pathology included under the designation fibrocystic diseases and other benign tumors have great clinical importance for two reasons, (1) They produce masses in the breast that require differentiation from carcinoma, and (2) They may predisposed to the subsequent development of carcinoma. Two diametrically opposite viewpoints have long been held equally vehemently, that fibrocystic diseases predispose to cancer, and there is no causal relationship between the two disorders. Warren (1964) in several years follow-up of 1200 cases of cystic disease, cites a cancer rate 4.5 times greater than in patients with normal breast. Other reports indicate that between 10 and 12 per cent of breasts with preexisting fibrocystic diseases of the breast develop cancer, two or threefold increased attack rate (Kilgore et al., 1953; Pessagno,1957). Looked at from the opposite point of view, 60 to 90 per cent of breasts with carcinoma have accompany cystic diseases. Notwithstanding these findings, the issue of the relationship of fibrocystic diseases to carcinoma is still unsettled, and many sti11 contend that there is no increased attack rate of carcinoma in breast having the pathologic changes of mammary dysplasia. The incidence of breast carcinoma is different geographically and racially. Among women in the United States and Europe, breast is the leading site of cancer in both incidence and mortality. But in Korea, Japan, other Asian and African countries, the incidence of breast cancer is low. Breast carcinoma may appear at any age in either sex. However, it is rarely encountered in persons under the age of 30 years of women and men. It occurs about 100 times as frequently in women as in men. The pathogenesis of the breast carcinoma is unknown, but hormonal factor, genetic factor, viral and traumatic factor are important role and precancerous lesions are considered from chronic cystic mastitis and papilloma of the breast. The overwhelming number of malignant tumors of breast parenchyma are carcinomas, and almost carcinomas of the breast are ductal in origin. It is important to divide breast carcinomas into different types. If these types can be identified, then some statement can be made of the probable extent of the lymph node metastases and thereby prognosis. So recently Tornberg’s classification (1960) is widely used. Tumor size, histologic types of breast cancer, location, nuclear grade, sinus histiocytosis of lymph nodes and invasion of blood vessels are features that have been claimed to be of prognostic significance of breast cancer. The most important single prognostic factor is the presence or absence of involved axillary lymph nodes. There are several reports on breast disorders among Koreans based on clinical and statistical aspects but there is no report on breast disorder, especially breast carcinomas based on histopathological aspects. The present study is an attempt to investigate mainly histopathological characteristics, such as classification of breast carcinoma according to cellular growth pattern, nuclear grade, sinus histiocytosis of lymph nodes, relationship between histologic types of breast carcinoma, location, nuclear grade and size vs. axillary lymph node metastases, and combined diseases of uninvolved breast parenchyma in breast carcinoma. Materials and Methods: The materials used in this study consists of 640 surgically resected breast tissue for 11 years from 1960 to 1970. Examinations of axillary contents were made when they were available. All specimens were fixed in 10% formalin. Grossly, the location and size of the tumor were examined. For histologic examinations, paraffin embedded blocks were cut in 6μ thickness and sections were stained by hematoxylin-eosin method. Histopathological studies on all cases of breast carcinoma are performed as follow; 1. histopathological classification of primary breast carcinoma by cellular growth patter of Tornberg's classification. 2. combined diseases of uninvolved parenchyma in breast carcinoma were determined by Kern and Brooks study (1969). 3. nuclear grade and sinus histiocytosis of lymph nodes. 4. size, location, nuclear grade and histologic types of primary breast carcinoma in relation to axillary lymph nodes. 5. lymphocytic infiltration to breast carcinoma. Other breast disorders, such as benign tumors, fibrocystic diseases and inflammatory diseases were also examined. For the all cases of primary breast carcinoma whose clinical records were available, sex, age, chief complaints, duration, blood types, marital and menstrual history and clinical axillary status were reviewed.
Results
and Summary: Clinical and histopathological studies were made on 640 surgically removed cases of breast lesions, that were submitted to the Department of Pathology, Yonsei University College of Medicine, during the period of 11 years from 1960 to 1970. 1. Among 640casesm 584 case(91.3%) were female, in which 217 cases(37.2%) breast carcinoma, 124 cases(21.2%) fibroadenoma and 134 cases(22.9%) mammary 요네ㅣ냠 were included. The ratio of male and female breast carcinoma was 1:37.2. 2. The average age of female breast carcinoma was 47.0 year0old, male breast carcinoma 56.3, fibro-adenoma 27.6 and mammary dysplasia 37.6. 3. The side distribution of the overall breast diseases was not significantly different, but breast carcinoma and mammary dysplasia were tend to the left slightly. 4. Clinical symptoms in order of frequency were as follows: palpable mass(95.2%), skin change(31.5%), pain(23.6%), and discharge(18.9%). The duration of chief complaints was the most common within six months(46.1%) and the average duration was 20.2 months. 5. Among 122 cases of female breast carcinoma, 115 cases(95.3%) was married, in which 36 cases(29.5%) had had history of sterility, and among 152 cases of female breast carcinoma, 43 cases(28.3%) the menstruation was irregular. 6. There is no relation between blood groups and incidence of breast carcinoma. 7. The location of the female breast carcinoma was the hghest in upper outer quadrant(40.0%) and the most frequent size was 3-6 cm(53.4%) in diameter of the mass and the average size was 4.5cm. 8. The histological types of the female breast carcinoma accordion to cellular growth patter in order of frequency were as follows: Type Ⅲ (39.2%), type Ⅱ (27.2%), type Ⅳ (27.2%) and type Ⅰ(6.7%). 9. Different from clinical vs. microscopic axillary nodes findings as follow: clinically - and pathologically - (53.5%), clinically - and pathologically + (46.5%), clinically + and pathologically + (80%), and clinically + and pathologically - (20%) 10. The metastases to axillary lymphnodes disclosed 63.7% and the larger the tumor, the more laterally located, the poorer the histopathological types and the poorer the nuclear grade, the more likely that axillary lymphnodes were involved. 11. there is no relation between nuclear grade, sinus histiocytosis or lymphocytic infiltration and histological types of breast carcinoma. 12. The cystic change was found in 62.6% of the breast carcinoma cases and was nearly as in the mammary dysplasia. Sclerosing adenosis, apocrine meta plasia and ductal papillmatosis were slightly more common in mammary dysplasia, but marked duck and lobular epithelial gyperplasea were more commonly associated with breast carcinoma. In conclusion based on above findings, it can be stated that breast carcinoma among Koreans examined in surgically removed specimens exhibited far advanced stage, both clinically, and histologically. The mammary dysplasia, especially combined with large duct hyperplasia was important to solve of patholgenesis of the breast carcinoma.

Cytology of Crush Preparation in Central Nervous System Lesion.: Young Il Yang, Sul Mi Park, Young Joo Kim, Shin Kwang Khang; Korean J Cytopathol. 1994;5(2):79-89.

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Abstract PDF: This study was performed in order to evaluate the accuracy and the usefulness of the cytology of crush preparation in central nervous system(CNS) lesions. Forty four intraoperative biopsies were performed at the time of craniotomy including 34 benign and 10 malignant lesions. Crush preparations were prepared from tiny tissue fragments of craiotomy products. All cases were stained with toluidine blue. Intraoperative diagnoses made on cytologic examination were compared with the final paraffin section diagnoses. Comparison between the results of the cytologic and histologic findings revealed an overall diagnostic accuracy of 88.6%. This study attests to the diagnostic accuracy of cytologic examination in CNS lesions. The detailed cytologic features are described and important criteria for the cytodiagnosis of CNS lesions are discussed.

Cytologic Features of Primary Tumors in Central Nervous System.: Soonae Oak, Jaegul Chung, Gyungyub Gong, Gheeyoung Choe, Eunsil Yu, Inchul Lee; Korean J Cytopathol. 1994;5(2):90-98.

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Abstract PDF: There has been a marked increase in the utility of aspiration cytology for pathologic diagnosis. It may be applied to any kinds of organs and substitutes surgical biopsy. Because of the high risk of complication and difficulties in localization, aspiration cytology in the central nervous system(CNS) has been used with less frequency compared to other sites. However, with the advent of sophisticated imaging instruments, aspiration cytology of lesions in the CNS is being used increasingly. Cytologic features of the CNS neoplasms were quite similar to those of histology except one spindle cell tumor. Reviewing various CNS neoplasms, it appears that cytology may be a useful diagnostic method.

Cytologic Analysis of Microinvasive Squamous Cell Carcinoma of the Uterine Cervix.: Eun Kyung Kim, Yee Jeong Kim, Jong Sook Park, Hy Sook Kim; Korean J Cytopathol. 1994;5(2):99-105.

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Abstract PDF: We studied cervical cytology of 175 cases of histologically confirmed microinvasive squamous cell carcinoma of the uterine cervix in Cheil General Hospital from 1991 to 1993. Excluding 32 cases of insufficient smear, 143 cases were reviewed in view of background, cellularity, smear pattern, nuclear chromatin and presence of nucleoli. The characteristic findings of microinvasive carcinoma were syncytia and/or individual tumor cells in the focally necrotic inflammatory background. Nuclear chromatin was clear or fine. Nucleoli were observed in 55%. The prediction rate of microinvasive carcinoma was 74%. There is no significant relationship between the cellular features and depth of invasion.

The Nature of Hepatocellular Ballooning Induced by Glucocorticoids in Rabbits and Rats -Histochemical and Electron Microscopical Studies-: Chang Eui Kang; Korean J Cytopathol. 1971;5(2):105-124.

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Abstract PDF: The presence of optically clear spaces in the cytoplasm of parenchymal cells of glucocorticoids treated liver sections are interpreted in various ways. Hill and Droke (1963) attributed the hepatocellular ballooning induced by parenterally administered cortisone to lipid accumulation, while Kim et al. (1969) thought it was due to glycogen accumulation. But Gans and McEntee(1961) and Thompson et al. (1971) studied these ballooning cells with special histochemical methods and demonstrated that the material distending the cells was neither glycogen nor lipid, and they speculated that the contents are probably water or diluted proteinic solutions. The role of cortisone and other corticosteroids in producing these alterations is still unknown and requires further study. The present studiers are undertaken in an attempt to identify the nature of these ballooning cells induced by glucocorticoids by histochemical and electron, microscopic studies. Materials and Methods ; Male albino rabbits weighing around 2.0 kg. and male albino rats weighing around 200 gms. were used for the experiment and divided into the following groups, one normally controlled and another glucocorticoids treated, which was in turn subdivided into cortisone acetate, prednisolone, and dexamethasone treated groups. The cortisone acetate prednisolone and dexamethasone were injected intramuscularly in a dose of 12. 0 mg., 3. 0 mg., and 0.6 mg, per kg. of the body weight per day. The serum glucose vague was determined by the methods of Folin-Wu both in the normally controlled and glucocorticoids treated groups with the blood drawn immediately before the animals were killed. Four rabbits of the control group were killed on the first, fifth and tenth day of the experiment and four rabbits of the glucocorticoids treated group on the 1st, 2nd, 3rd, 4th, 5th, 7th, and l0th day and two albino rats from each group on 1st, 5th and l0th day. Overall histologic alterations were observed by routine hematoxylin-erosin staining technic, and PAS, D-PAS staining for mucopolysaccharides and glycogen, and Oil red-O staining for lipid demonstration were applied. For the electron microscopic examination the tissue was filed twice, first with 4% glutaraldehyde in phosphate buffer of PH 7.4 followed by 1% osmium tetraoxide in phosphate buffer of pH 7 4 for 2-hours, and embedded in Epon 812 following dehydration with graded alcohol. Sections were made with a glass knife of 400 to 500Å thickness and stained with uranyl acetate and lead hydroxide. Observation was made with Hitachi II-E model electron microscope.
Results
and Discussion ; The adiministration of glucocorticoids to rabbits and albino rats resulted in a slight decrease in body weight, whereas the liver weight significantly increased in the animals receiving glucocorticoids. But the water content of the liver remained unchanged. Histological examination of rabbits receiving glucocorcoticoids revealed a marked ballooning and vesicular appearance of the hepatic cells in the mid-zonal and periportal areas of hepatic lobules. The maximal intensity of ballooning and vesicular cytoplasmic changes in liver was observed in dexamethasone treated rabbits followed by prednisolone and cortisone acetate treated rabbits. Special stains and electron microscopic studies demonstrated that the material distending the hepatic cells was glycogen only in the rabbits. But in the rats, the ballooning and vesicular changes of the hepatic cells were very mild in comparison to the rabbits, and moreover special stains and electron microscopic studies demonstrated that the nature of the ballooning cells was the result of a combination of glycogen with lipid accumulation. The glycogen accumulation was accompanied by marked proliferation of SER, but the proliferation of SER appeared to be the secondary to glycogen accumulation. After a maximal SER proliferation, further glycogen accumulation was not demonstrable in spite of repeated glucocorticoids treatment. Summary ; The nature of hepatocellular ballooning induced by glucocorticoids treatment is due solely to glycogen accumulation in the rabbits, while it is due to a combination of glycogen with lipid accumulation in the rats, indicating that there existed a species difference in the reaction to glucocorticcids. The marked SER proliferation without glycogen accumulation appeared to be the result of glycogen accumulation rather than to be a cause, and more likely concerned with glycogenolysis.

Cytologic Classification of Fibrocystic Disease of the Breast: A Proposal for Use of Cytologic Criteria Grading System.: Hye Kyoung Yoon, Chan Hwan Kim, Jong Eun Joo, Shin Kwang Khang; Korean J Cytopathol. 1994;5(2):106-112.

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Abstract PDF: Fine needle aspiration biopsy has been proved as a safe, accurate and cost-effective diagnostic modality in palpable breast lesions. Cytologically, fibrocystic disease can be classified into 3 categories as nonproliferative breast disease, proliferative breast disease without atypia, and proliferative breast disease with atypia. This terminology for the needle aspirates is compatible with that of diagnostic histopathology. Cytologic differentiation of nonproliferative disease from proliferative breast disease is important, since the risk of cancer development in cases of atypical hyperplasia is 4-5 times higher than that of general population. Twenty five needle aspirates of fibrocystic disease confirmed by subsequent histopathology were re-evaluated and classified into 3 categories depending on their architectural and nuclear features. In addition. these aspirates were scored according to the cytologic grading system, devised by Masood et al. and based on six cytologic criteria. Concordance rates between cytomorpholgic diagnosis and cytologic diagnosis using the cytologic criteria grading system and histologic diagnosis were 88% and 92%, respectively.

Case Report

Fine Needle Aspiration Cytologic Findings of Kikuchi's Lymphadenitis: Analysis of 30 cases.: Hyun Ju Yoo, Hye Je Cho, Ill Hyang Ko; Korean J Cytopathol. 1994;5(2):113-119.

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Abstract PDF: Thirty cases of kikuchi's lymphadenitis, diagnosed by fine needle aspiration cytology, were reviewed to determine the main cytologic features helpful in reaching a diagnosis. The patients(mean age 26.6 years. male: female=1:3.8) presented with lymphadenopathy(cervical 24, submandibular 3, and axillary 1) with or without fever and local tenderness. Excisional biopsy was done for confirmation in 5 cases and the remaining 25 cases showed the similar cytologic and clinical features. In the aspiration smears of all cases. there was a heterogenous cellular mixture including frequent extracellular karyorrhectic nuclear debris, phagocytic histiocytes, plasmacy toid monocytes, and a variable number of polymorphous lymphocytes such as immunoblasts. activated large lymphocytes, and small mature lymphocytes, The characteristic cytologic features of kikuchi's lymphadenitis were the following: (1) frequent extracelluar karyorrhectic nuclear debris in the background: (2) phagocytic histiocytes with eccentrically placed crescentic nuclei and abundant pale cytoplasm containing phagocytized karyorrhectic debris: (3) plasmacytoid monocytes, which were medium-sized cells with eccentrically placed round nuclei and amphophilic cytoplasm: (4) no neutrophilic background.

Original Articles

A Cytologic Study of Fine Needle Aspiration Biopsy of Salivary Gland Diseases.: Mi Jin Kim, Tae Suk Lee; Korean J Cytopathol. 1994;5(2):120-129.

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Abstract PDF: Fine needle aspiration biopsy cytology is a widely recognized and useful technique which can provide diagnosis in lesions of the head and neck, enabling appropriate management plans for individual patient to be made. Fifty one fine needle aspirates from salivary gland masses were examined. Four aspirates(8%) were inadequate for examination. Of the remaning 47 samples, 42 cases(82%) were benign lesions which consist of 30 pleomorphic adenoma(58%), 7 inflammatory lesion(14%) 4 Warthin's tumor (8%) and 1 benign lesion(2%). Two cases(4%) were atypical lesions. Three case(6%) were malignant lesions consisting of 2 adenoid cystic carcinomas(4%) and 1 mucoepidermoid carcinoma(2%). The cytologic diagnoses were compared with the subsequent histologic diagnosis of surgical resected specimen in 24 cases. 19 cases of 21 aspirates from benign tumors were correctly diagnosed by fine needle aspiration cytology, with a specificity of 90%. All 3 aspriates from the 3 patients with malignant tumor were correctly diagnosed by fine needle aspiration cytology, with a sensitivity at 100%. Overall acurracy was 88%. Diagnostic error was encountered in adenoid cystic carcinoma, mucoepidermoid carcinoma and warthin's tumor. Correct histologic diagnosis was made in 86% of benign tumors(84% for pleomorphic adenoma and 100% for Warthin's tumor) and in 100% of malignant tumors.

Ultrastructural Changes of Rat Liver Cells Induced by Large Doses of Vitamin A: Sang Hyok Nam; Korean J Cytopathol. 1971;5(2):125-141.

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Abstract PDF: Lysosomes are the main component of an intracellular digestive system which has been recognized in a wide variety of cells, both in plants and animals. They were first discovered in rat livers, by do Duve et al. (1955), through biochemical studies that revealed the existence of a distinct group of cytoplasmic particles, surrounded by a membrane, and containing acid hydrolases. Lysosomes are important in cellular pathology because they are almost invariably involved in the response of the organism to the challenging agents and because the lysosomal reaction often becomes an important contributing pathogenic factor as well as a component of the symptomatology. Lysosomes may also mediate tissue damage by releasing their enzymes directly into the cell sap or surrounding tissues. Such an effect was observed following the addition of excess vitamin A to fetal bone rudiments in organ culture(Fell and Thomas, 1960; Thomas et al., 1960; Dingle, 1963). The exact mechanism of the effect of excess vitamin A on the membranes of lysosomes is still controversial. The mechanism of intracytoplasmic release of lysosomal hydrolases facilitated by the action of vitamin A is thought to be either rupture of the lysosomal membrane(Dingle and Fell, 1961 ; Weissmann et al., 1963; do Duve, 1963; Roels et al., 1969), or leakage across the lysosomal membrane (Schin and Cleven, 1965; Trump et al., 1965; Weissmann, 1965; Comolli, 1967; Friedman et al., 1969). The purpose of the present study is to determine the effect of excess vitamin A to the lysosomal membrane and the stabilize effect of cortisone. Materials and Methods: Sixty five adult albino rats weighting around 200 gm. were used regardless of their sex. The mental animals were divided into three groups as follow: Group Ⅰ : control animals (7 rats) Group Ⅱ : animals treated with large doses of vitamin A(29 rats) Group Ⅲ : animals treated with large doses of vitamin A and cortisone (29 rats) Vitamin A was administered orally in the amount of 500 international units per 1 gm. of body weight daily. Cortisone was injected intramuscularly in a dosage of 0.05 mg. per 1gm. of body weight daily. The control animals received salada oil only with the same volume as vitamin A treated animals. The rats from each experimental group and one from control were killed respectively on the first, third, 5th, 7th, 10th, 15th and 20th days after adminitration of vitamin A and vitamin A with cortisone. The liver tissues for the light microscopic examination were obtained immediately. For the light microscopic examination, tissues were fixed in 10% neutral formalin and embedded in paraffin. Six μ thick sections were made and stained with hematoxylin-eosin, and periodic acid Schiff reaction for glycogen. Frozen sections were also made to be stained for fat with oil red O. Blocks of liver for routine electron microscopic analysis were fixed in 1% osmium teraoxide with veronal buffer (PH 7.4) at 0-4°C. these were dehydrated, embedded in Epon, and examined in Hitachi HU-IIE electron microscope after staining with uranyl acetate and lead hydroxide. Electron microscopic histochemical demonstration of acid phosphatase was accomplished as follows: Thin slices of liver were fixed for 2-4 hours in cold 4% sodium cacodylate-buffered glutaraldehyde and washed overnight in cacodylate buffer containing 7.5% sucrose. Small cubes of tissue were then incubated according to Gomori method for the demonstration of acid phosphatase. The incubated tissues were then postfixed in osmium teraoxide, dehydrated and embedded in Epon. these sections were examined unstained in the electron microscope.
Result
and Discussion: In the light microscopic examination in group Ⅱ, vacuoles in the liver cells were limited to the peripheral zone and extended to midzone by 7th day and were persistent throughout the remaining periods of the experiment. These vacuoles were found to be fat droplets by oil red O stain. Necrosis or ballooning of liver cells were not found. In groups Ⅲ, ballooning of liver cells was noted on the first day after treatment and extended and persisted throughout the remaining periods of the experiment. At the 10th day, fat vacuoles were also found with ballooning of liver cells. Slight dilatation of rough endoplasmic reticulum and normal appearance of lysosomes were observed on the third day in group Ⅱ by electron microscopic examination. But the activity of acid phosphatase was aggregated outside the lysosomes and intracytoplasm. It is suggested that the excess vitamin A facilitated the leakage of enzymes across the lysosomal membranes rather than actual rupture. On the 5th day in group Ⅱ, the rough endoplasmic reticulum was made dilated and noted the part of desruction of cytoplasm and acid phosphasases were distributed intracytoplasm and along the rough endoplasmic reticulum. It is suggested that thease change were caused by released and newly formed enzymes. In the more deranged cytoplasm, presence of lipid droplets and myelin figures were noted on the 7th day in group Ⅱ. In group Ⅲ, the cytoplasmic organelles were more preserved than in group Ⅱ. The release of acid phosphatase was delayed. In summary, severe injury of liver cells was not produced by the administration of large doses of citamin A. However, mild fatty changes were observed. The intracytoplasmic release of acid phosphatases of lysosomes is considered to be due to the increase of permeability of the lysosomal membrane rather than the rupture of it. Cortisone appears to delay both formation of lipids and release of lysosomal enzymes.

Urinary Cytologic Findings of Urothelial Lesions.: Yoon Jung Choi, Kwang Gil Lee; Korean J Cytopathol. 1994;5(2):130-136.

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Abstract PDF: Urinary cytology is increasingly accepted as a diagnostic tool in the detection and follow-up of patients with bladder cancer. However, its value is reduced by several limitations, especially by the tack of cytologic criteria specifically reflecting the morphology of low-grade urothelial neoplasm. We reviewed histologically proven 50 cases of urine cytology with emphasis on cytologic findings of benign atypia and differential findings of urothelial neoplasm according to the grade. The diagnoses included 17 benign lesions (including 5 cases of urine calculi) and 33 malignant lesions(including 28 transitional cell carcinomas. 3 squamous cell carcinomas, 1 adenocarcinoma and 1 prostate adenocarcinoma). Diagnostic accuracy was 92%. Important cytodiagnostic criteria for benign atypia and low grade malignancy were cellularity, number of cell clusters, and morphology and arrangement of urothelial cells. The cytologic findings of urothelial neoplasms according to histologic grade were relatively well correlated with the histologic findings. However, the cytologic criteria were not sufficient to readily distinguish grade I from grade II. In view of this, we think that cytologic nomenclature "low-grade" and "high-grade" is a more reliable criterion. Recognition of subtle cellular morphologic features specific for urothelial lesions(including benign or malignancy) and proper fixation, processing and staining of specimen can expand the role of urinary cytology in detection and follow-up of patients.

Case Reports

Urine Cytology of Renal Cell Carcinoma: Analysis of 11 cases.: Yi Kyeong Chun, Hye Jae Cho, Ill Hyang Ko; Korean J Cytopathol. 1994;5(2):137-142.

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Abstract PDF: Urine cytology is of limited value in the diagnosis of renal cell carcinoma with reported detection rates of 0~80%. The aim of this study is to demonstrate the usefulness of urine cytology in renal cell carcinoma, In the eleven histologically proven cases of renal cell carcinoma, urinary smears were reevaluated. The cytologic results were as follows; positive for malignant cells in 3 cases (27%), suspicious in 2 cases (18%) and negative in 6 cases (55%). The average diameter of the tumor of the 5 cases reported as positive or suspicious for malignant cells was 9.7cm and 3 had invaded the renal pelvis. The other 6 tumors, reported as negative, were 5.7cm in average diameter and one of them showed involvement of the renal pelvis. These results suggest that urine cytology is considered unsatisfactory in the early detection of renal cell carcinoma. However. careful examination of urinary smear could improye the detection rate especially in more advanced cases involving the renal pelvis as well as those of larger tumors.

Fine Needle Aspiration Cytology of Gynecomastia: Review of 14 Cases.: Hye Kyoung Yoon, Seol Mi Park, Jong Eun Joo; Korean J Cytopathol. 1994;5(2):143-147.

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Abstract PDF: Fine needle aspiration cytologic findings in 14 cases of gynecomastia are described. General cytomorphologic features resemble those of fibrocystic disease in women than those of fibroadenoma. Among the cytologic parameters, three-dimensional structure of epithelial cell clusters, presence of micronucleoli and irregularities of nuclear size and shape are suggestive of epithelial proliferative activity. In addition, 4 cases are proliferative breast disease without atypia and 10 cases are nonproliferative breast disease depending on cytologic criteria grading system.

Original Articles

Statistical analysis and histopathological study on hepatic diseases among Koreans: Chung Hee Chi; Korean J Cytopathol. 1971;5(2):143-147.

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Abstract PDF: Total 337 cases too liver biopsy specimens and 98 autopsy cases of hepatic diseases obtained at the National Medical Center during the period of 1958 to 1968 were histopathologically examined with statistical analysis for international classification of diseases and correlation between clinical diagnosis and histopathological diagnosis was made. As the result of present study the following conclusions were obtained. 1) By sex, number of male is dominant than female in both biopsy 229 cases (male), 108 cases (Female) 2.1 : 1, and autopsy cases 72(%ale), 26(Female) 2.8 : 1. 2) Among the groups of hepatic lesions cirrhosis is 80.5% (M 4l. 6%, F 38.9%) with highest incidence in biopsy material and average age is 34.5 years. Identical findings are seen in autopsy cases with 57 cases (M 40, F 17) out of 98 cases with the range of 55.6% (M) and 65.4% (F). 3) Post hepatitic cirrhosis is highest among the cirrhotic groups of biopsy material with 88 cases (M 66, F 22) out of total cirrhosis cases of 137(M 95, F 42) and portal 22 cases (15 M, 7 F), post necrotic 15 cases (9 M, 6 F), biliary 7 cases (4 M,3 F) as in decreasing order with exceptional 1 case of nutritional Cirrhosis. 4) Average age of tumor is 44. 1 years and somewhat higher than that of cirrhosis 34. 5 years. Tumors among the biopsy material revealed highest incidence of hepatoma 61 cases, extra bile duct ca. 66 cases, and cholangioma 8 cases in decreasing order. 5) In autopsy material age distribution and frequency of hepatic diseases were mostly similar to that of the biopsy material, however, abscesses were comparatively higher in cadaver material. Post hepatitic cirrhosis was 36 cases out of 137 cases and 16 cases of post necrotic cirrhosis was next to the highest incidence. 6) Analytic pilot study for various histopathologic findings to evaluate the grouping of the hepatic lesions (biopsy) without knowing of previous clinico-pathologic diagnosis or laboratory findings showed no remarkable or significant difference among the disease groups. 7) Correlation between clinical and pathologic diagnosis showed considerable percentage of difference. The difference in abscess and hepatitis was only 9.1%.

Results of Sputum Cytology in Diagnosis of Lung Cancer: Based on the Results Obtained for 16 months in Presbyterian Medical Center.: Hye Kyung Lee, Kwang Min Lee, Dong Kyu Chung, Dae Song Kang, Kwi Wan Kim; Korean J Cytopathol. 1994;5(2):148-153.

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Abstract PDF: A prospective survey of sputum cytologic specimen was performed for 16 months from Jan. 1993 to Apr. 1994 in Presbyterian Medical Center. The purpose of this study is to find the positive rate of sputum cytology in the diagnosis of lung cancer and to correlate these results with tumor location and stage. Sputum cytologic specimen were received from 104 patients among 168 patients diagnosed as lung malignancy by histologic examination. Cytologic diagnosis of "suggestive of malignancy" was made in 61 patient(59%) and dysplasia in 9 patients(9%), atypia in 14 patients(13%), benign in 15 patients(14%) and inadequate specimen in 5 patients(5%), respectively. Among 84 patients beyond the cytologic diagnosis of atypia, 51 patients(61%) disclosed a central location, while 33patients(39%) showed peripheral lesions. All 54 patients diagnosed as suggestive of non-small cell carcinoma were stage III or over, and all 7 patients diagnosed as suggestive of small cell carcinoma were in advanced stage.

A Modified Garry’s Micro-method for the _Determination of Serum Cholinesterase: Ki Hong Kim, Joo Sup Lee; Korean J Cytopathol. 1971;5(2):149-153.

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Abstract PDF: Garry’s original method was modified for purpose of useful laboratory practice. In this modified method authors use only 5ul of serum instead of 20㎕, and incubated for 15minutes instead of 3 minutes. The results were very satisfactory.

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