Journal of Pathology and Translational Medicine

Volume 6(2); December 1995

Original Articles

The Bethesda System(TBS): A New Reporting System of Cervicovaginal Smear.: Hy Sook Kim; Korean J Cytopathol. 1995;6(2):85-98.

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Abstract PDF: In 1989, the Bethesda System(TBS) was introduced as an attempt to standardize cervical/vaginal reporting systems. TBS nomenclature was created for reporting cytologic diagnoses to replace the currently used Cervical Intraepithelial Neoplasia(CIN) and Papanicolaou Class System which are deemed less reproducible. The name for preinvasive squamous lesions was changed to squamous intraepithelial lesion(SIL), subdivided into low-grade and high-grade type. TBS recommends a specific format for cytologic report, starting with explicit statement on the adequacy of the specimen, followed by general categorization and descriptive diagnosis. Pathologic and epidemiologic studies performed over last 10 years have provided evidence that human, papillomavirus(HPV) plays a significant role in the development of cervical neoplasia. TBS corresponds not only to currently held views of the behavior of preinvasive lesions and their HPV distribution, but also to the current guidelines for clinical management.

Morphometry of Nuclei in Adenocarcinoma of Prostate.: Hye Rim Park, Seung Wan Char, Jin Hee Sohn, Young Euy Park; Korean J Cytopathol. 1995;6(2):99-105.

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Abstract PDF: Morphometry of nuclei of the benign and malignant prostatic lesions was performed to study the relationship between nuclear size and shape and the prognosis of prostatic adenocarcinoma. Fifty one cases of prostatic adenocarcinoma and 13 cases of benign prostatic hyperplasia were included to evaluate area, perimeter, Dmax, Dmin, and 5 form factors of the nuclei by image analyzer(Zeiss Ibas 2000) using hematoxylineosin stained slides. All analytic factors of nuclear size and shape were significantly different between benign lesions and adenocarcinomas. Increased nuclear size was associated with nuclear irregularity, presence of metastasis, advanced clinical stage, and high Gleason's grade and score of prostatic adenocarcinoma. On Kaplan-Meier method, survival was decreased with older age, no hormonal treatment, stage D, high Gleason}s grade and stage as well as with larger size and irregular shape of the nuclei. In conclusion, morphometry of nuclei of the prostate can be a helpful tool to differentiate between benign and malignant lesions. Nuclear morphology is thought to be associated with prognosis of prostatic adenocarcinoma.

Immunocytochemical Characteristics of the Short-term cultured Mesothelial Cells.: Ho Jong Jeon, Mi Ja Lee, Mi Sook Lee, Yu Kyung Jeong, Young Mi Lee, Hyung Ho Choi; Korean J Cytopathol. 1995;6(2):106-115.

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Abstract PDF: Reactive human mesothelial cells were examined by immunocytochemical stain with intermediate filaments(cytokeratin [CK1, CK7, CK8, CK18, CD19/, vimentin, desmin, actin), epithelial membrane antigen, carcinoembryonic antigen(CEA), MHC class II antigen(HLA-DR), LeuM-1(CD15), alpha1-antitrypsin(ACT), alpha1-antichymotrypsin (ACHT), CD68(KP-1) and FcgammaRIII(CD16). The mesothelial cells were isolated from patients with liver cirrhosis and pleural effusion, and short-term cultured in RPMI 1640 media containing 10% heat inactivated fetal calf serum and 1% identical supernatant fluid of the patients' transudates. The results obtained are as follows. 1. The cultured-reactive mesothelial cells were positive for the protein of cytoskeleton such as cytokeratin and vimentin, but negative for desmin and actin. The resting mesothelial cells showed positive reactions for cytokeratin, but negative for vimentin, desmin and actin. 2. The primary antibodies to the cytokeratin were strongly reactive for CK1, CK8 and CK18 but negative for CK7 and CK19 in both reactive and resting mesothelial cells. 3. Resting mesothelial cells showed negative reactions for CEA, but strong positive reactions in cultured-reactive mesothelial cells. 4. The markers for the monocytes\histiocytes (CD11b, CD14, CD16, CD68, lysozyme and alpha1-antitrypsin and alpha1-antichymotrypsin) were nonreactive in resting mesothelial cells, but lysozyme and alpha1-antitrypsin were weakly reactive in reactive and proliferative mesothelial cells. 5. MHC Class II molecule(HLA-DR antigen) was negative in both resting and reactive mesothelial cells. These results suggest that the short-term cultured, reactive mesothelial cells show a newly aberrant expression of the vimentin and carcino-embryonic antigen. The reason of the aberrant expression of the intermediate filament and oncofetal antigen in reactive and proliferative mesothelial cells should be further evaluated.

Etc

Histopathological study on chronic congestive splenomegaly: Chung Hee Chi; Korean J Cytopathol. 1972;6(2):115-122.

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Abstract: The spleen consisted of mesenchymal tissue mainly with splenic cord is specific organ on the circulatory point of view that communicating to the portal system and bearing quite characteristic structure different from ordinary capillaries playing a role as terminal route of end circulation where arteriovenovs shunt exists. And changes in splenic cord is sensitively occur under variable conditions. It is quite natural that circulatory disturbance in portal system giving rise considerable influence to the splenic histologic architecture. A number of previous reports for normal anatomical and structural studies on splenic cord (1, 3, 4, 5) are rather limited to cellular component in splenic cord and not extended to the changes of lattice fiber in process of demolishing or reconstructing pattern in congestive splenopathy. Koboth’s study on splenic cord by reconstruction of tissue sections revealed regular arrangement of lattice fiber that contributed to basic ideal pattern to be investigated to understand pathological changes in chronic congestive splenopathy (splenomegaly). Material and Method: Among 98 autopsy cases (male-72, female-26) associated with underlying cause of hepatic diseases, examined at the National Medical Center during the period of last 10 years from 1958 to 1968, 50 cases (male-39, female-11) of chronic congestive splenomegaly were selected and classified by sex, age and in disease group. Also statistical study on correlation between liver and spleen in weight was made. For histopathologic findings ordinary paraffin section of Hematoxylin Eosin(H-E) staining, Masson’s Trichrom(collagen), Weigret Elastic Van Gieson (Elastic fiber), and Grocott Methenamine-Silver (Lattice fiber) staining were performed to observe the changes of lattice fiber in splenic cord during the course of hepatic diseases with splenomegaly.
Result
1. Age on motality showed no significant difference in sex. Age distribution in disease group reveal hepatic abscess 5-29y, hepatoma 35-55y, cirrhosis 9-59y, and average 24.5, 34.2 and 44.5 year respectively. 2. No remarkable sex difference is noted in frequency of hepatic abscess. But cirrhosis group showed ratio of 25 : 8 (male: female) and hepatoma group 13 : 1 with dominant incidence in male. 3. In cirrhotic group average of liver and spleen with standard deviation are as follows 933.34±268.74g., 470.83g±225.42g. and reveals moderate atrophy or shrinkage of liver and splenomegaly. Correlation coefficient between liver and spleen is r= -0.25 indicating slight reverse correlation. Regression line quotent spleen(χ) to liver(y) and liver to spleen is χ= 668.23-0, 12ｙ, and ｙ= 1074.87-0.30χ respectively. 4. In hepatoma group average weight of liver and spleen with standard deviation are as follows 2354.56g±688.04g, 265.91g±87.43g. and reveal pronounced hepatomegaly associated with mild splenomegaly. Correlation coefficient between liver and spleen is r= -0.41 presenting slight reverse correlation. Regression line quotent spleen to liver and liver to spleen is χ= 658.23-0.21y, and ｙ=1074.87-0.30y respectively. 5. Hematoxylin-Eosin stain revealed no definite structural alteration except sinusoidal distension, endothelial proliferation, widening of splenic cord and periarterial fibrosis in Malpighian corpuscles. 6. Alteration of lattice fiber is quite characteristic with dissociation of GF (Grenzfaser), fine network formation, nextly forming small sinuses dividing in to splenic cord, from which histologic architectural changing process in splenomegaly due to portal hypertension is partly explainable. 7. Senile spleen with ordinary hematoxylin-Eosin (H-E) stain showed no much difference from mild degree of splenomegaly. However, silver staining for lattice fiber reveals further complicating findings than splenomegaly with atrophy or destruction of cord bearing fragmentation of R.F. and demolishing of Mgm, and Mmf. No evidence of newly forming sinuses is noted. 8. Special staining employed for collagen and elastic fiber had not given much contribution on the histological study of splenomegaly.

Original Articles

Cytologic Analysis of Malignant Effusion.: Sang Pyo Kim, Ji Yeon Bae, Kwan Kyu Park, Kun Young Kwon, Sang Sook Lee, Eun Sook Chang, Chung Sook Kim; Korean J Cytopathol. 1995;6(2):116-124.

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Abstract PDF: Eighty cases of malignant effusion were cytologically studied to elucidate the incidence of primary tumor site and cytologic characteristics of each tumor types. Eighty fluid specimens were composed of 43 ascitic, 35 pleural, and 2 pericardial effusion and primary tumor site had been confirmed by histology. The frequent primary sites were stomach (22 cases, 28%), lung (21 cases, 26%), ovary (11 cases, 14%), liver (7 cases, 9%), and breast (4 cases, 5%). The principal malignant tumors were adenocarcinoma (56 cases, 70%), squamous cell carcinoma (7 cases, 9%), liver cell carcinoma (7 cases, 9%), small cell carcinoma (4 cases, 5%), and non-Hodgkin}s lymphoma (4 cases, 5%). The distinctive cytologic findings according to primary tumor types were as follows ; the gastric adenocarcinomas were mainly characterized by isolated cells and irregular clusters sometimes with signet ring cells. Papillary serous cystadenocarcinoma of ovary showed frequently papillary clusters and occasional psammoma bodies. Breast carcinoma of ductal type showed cell balls with smooth margins. Colonic adenocarcinoma showed rather irregular clusters or palisading pattern of cylindrical cells. Metastatic squamous cell carcinoma, liver cell carcinoma, small cell carcinoma, and non-Hodgkin}s lymphoma showed also characteristic features. These findings indicate that the cytological features observed in the great majority of malignant effusion are similar to those of primary tumor types, which are very helpful to indentify the primary tumor site.

Cytologic Analysis of Metastatic Malignant Tumor in Pleural and Ascitic Fluid.: Mee Joo, Hye Je Cho; Korean J Cytopathol. 1995;6(2):125-132.

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Abstract PDF: Cytodiagnosis of pleural and ascitic fluid is a commonly performed laboratory examination. Especially, positivity for malignant cells in effusion cytology is very effective and also presents the first sign of malignancy in unknown primary site of the tumor. We examined each 34 cases of pleural and ascitic fluid cytologic specimen diagnosed as metastatic tumor, which was selected among 964 pleural fluid cytology cases and 662 ascitic fluid cytology cases from September 1989 to June 1995. Among the ascitic fluid cytology specimens examined, 34 specimens were positive in 29 patients. The most common primary neoplasms were carcinomas of ovary (32%), stomach (32%), colon (6%), breast (3%), pancreas (3%), and lung (3%) and lymphoreticular neoplasms (3%). The metastatic tumor was predominantly adenocarcinoma type in both pleural (82%) and ascitic (91%) fluid. The study of metastatic adenocarcinoma in effusion from lung, ovary, and stomach was undertaken to find distinctive features for the identification of the primary site. The smears of metastatic pulmonary adenocarcinoma had a tendency to show high grade pleomorphism and many large tight cell clusters, whereas that of the ovarian adenocarcinoma showed low grade pleomorphism with abundant intracytoplasmic vacuoles in relatively clear background. That of the stomach revealed the intermediate features.

Etc

A Study on H.A.A. and Liver Function Tests in Professional Donors and Viral Hepatitis Patients: Moon Hyang Park, Sung Yong Paik; Korean J Cytopathol. 1972;6(2):125-133.

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Abstract: The author has performed H.A.A. and liver function tests with sera from 200 Korean male professional donors and 41 viral hepatitis patients to understand the frequency of H.A.A. in both group and relation between H.A.A. and liver function test. The results were as following: 1. H.A.A. was detected in 10% of Korean professional blood donors. 2. The incidence of H.A.A. positivity was 14.6% in the adult viral hepatitis. 3. In H.A.A. positive donor group, significant increase in mean value and frequency of abnormal value than H.A.A. negative donor group was noted in T.T test. 4. In H.A.A. positive viral hepatitis group, increase in mean value and frequency of abnormal value than H.A.A. negative hepatitis group was noted both in alkaline phosphatase activities and γ-globulin content.

Original Article

Analysis of Transthoracic Fine Needle Aspiration Cytologic Diagnoses of Pulmonary Nodules.: Chan Kum Park, Jung Dal Lee; Korean J Cytopathol. 1995;6(2):133-139.

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Abstract PDF: To evaluate the sensitivity and specificity of transthoracic fine needle aspiration cytology(TFNAC) in the preoperative diagnosis of pulmonary nodules, a retrospective analysis was carried out on a consecutive series of 200 TFNACs. They included 186 primary malignant tumors, 66 squamous cell carcinomas, 65 adenocarcinomas, 36 small cell carcinomas, 7 large cell carcinomas, 4 carcinoids, 8 others, 9 metastatic tumors, and 5 benign tumors. On cytohistologic correlation of malignant pulmonary tumors, the procedure had a sensitivity of 97.3% and a specificity of 100%. A 86.6% correct correlation between the cytologic and histologic diagnoses was achieved. Five out of the 7 undifferentiated large cell carcinomas, 10 out of the 65 adenocarcinomas, 2 out of the 36 small cell carcinomas, and 2 out of the 66 squamous cell carcinomas were turned out to be mistyped in cytologic diagnosis. We concluded that TFNAC is a highly sensitive and specific preoperative diagnostic procedure in the investigation of patients with discrete pulmonary nodules in whom the specific cell type of the malignant neoplasm has important implications in treatment modality and prognosis.

Etc

Clinico-pathologic Studies of the Liver Biopsies among Koreans: Chan Il Park, Yoo Bock Lee, Dong Sik Kim; Korean J Cytopathol. 1972;6(2):135-148.

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Abstract: Liver is, of course, a most important organ biochemically and physiologically, and if we consider the wide range of diseases involving the liver, the importance must be emphasized again in pathological field. But still the etiology and/or pathogenesis of some hepatic lesions especially cirrhosis have not been clearly understood, and so classification of liver cirrhosis has not hither to been solved. Furthermore, in the clinical aspect, the performance of needle biopsy has been rising for the physicians’needs to confirm the provisional impression by tissue diagnosis. Therefore difficulty in the diagnosis of the needle biopsied liver tissues has become a problem to the pathologists. Meanwhile, in Korea, in spite of the high incidence of liver diseases probably due to the average low protein diet which would result in decreased states of the liver function, results of other races who were different in cultural and environmental back ground have frequently been cited because of the rarity of exact records on the whole liver diseases among Koreans. Considering the above subjects, this study is to provide the incidence of liver diseases and to ensure the frequent occurrence of primary liver carcinoma in Korea, on morphological basis Materials and Methods ; The materials used in this study consisted of 951 liver biopsies obtained during the period from Jan., 1960 to Jun., 1971. For histologic studies, the specimens filed with 10% formalin were followed by paraffin embedding and were cut in 6 μ thickness. Sections were stained with hematoxylin-eosin for routine examination, and the biopsies obtained since May, 1970 were all stained with in addition to hematoxylin-eosin, Gomori’s silver impregnation for lobular architecture and reticulin pattern and Masson’s trichrome for connective tissue. Stains for bile or iron were also done in cases of needs. Histopathological classification was made as follows for convenience, 1. diffuse hepatitis, 2. liver cirrhosis, 3. neoplasm and 4. miscellaneous diseases. Diffuse hepatitis included acute hepatitis, chronic active and inactive hepatitis, cholangiolitis neonatal hepatitis and nonspecific reactive hepatitis of Schaffner and Popper (1957, 1959) Liver cirrhosis was subclassified as macronodular, micronodular cirrhosis and biliary cirrhosis by the size and shape of the cirrhotic nodules(Popper and Schaffner, 1968; Scheuer, 1970). On the macronodular cirrhosis, the degree of differentiation was made according chiefly to the evidence of parenchymal collapse or not, whether the cirrhotic nodules revealed resemblance of lobular pattern, and to whether the portal tracts and efferent veins could be identified or not. Based on the criteria of Popper et al. (1965), activity of the macro- and micronodular cirrhosis was also examined, which was then closely compared with serum transaminase level. Hepatoblastoma was inc]used to the primary carcinoma of the liver and was subclassified as epithelial type and mixed type (Ishak and Grunz, 1967 ; Ito and Johnson, 1969). Combined or associated pathology of the primary liver carcinoma was also examined. Congenital liver diseases, including intra- or extrahepatic biliary atresia, passive congestion, fatty metamorphosis, clonorchiasis and granulomatous diseases were all comprised in the misce]laneous category, because of their rarity. Clinical records and laboratory data were reviewed and compared with the tissue findings.
Results
and Summary ; Histopathological and clinical studies were made on 951 liver biopsies submitted to the Department of Pathology, Yonsei University College of Medicine, during the period from Jan., 1960 to Jun., 1971, and the results were as follows. 1. Among 951 liver biopsies, 827 (87%) cases were available for the study, excluding insufficient tissues. And big three hepatic diseases in Korea based on biopsy were diffuse hepatitis, liver cirrhosis and neoplasm, marking 33.0%, 27.9% and 24.8% respectively with the sum of 85.7%. 2. Diffuse hepatitis was encountered in 273 cases with the sex ratio of 2.5 : 1 and the average age of 41.5 year-old. More than half (141 cases) of the diffuse inflammatory lesions were chronic inactive and nonspecific reactive hepatitis. In contrast, acute hepatitis diagnosed by the tissue pathology was far less common (28 cases) and it was likely the cause that acute viral hepatitis was somewhat conventional clinically and the biopsy was frequently contraindicated when the patient was in icteric state. 3. Neonatal hepatitis was found in 13 cases and of them only 8 showed giant cell transformation of the liver cells. 4. Cirrhosis was encountered in 231 cases with the sect ratio of 5.2 : 1 and the average age of 48.8 year-old. 149 cases(64.9%) were regarded as macronodular and 45(19.5%) as micronodular cirrhosis. 5. 74 cases of macro-and 30 cases of micronodular cirrhosis were histologically active and the active one tended to show-more frequently the serum transaminase level of higher than 40 unit/cc. But the degree of increment in serum transaminase was not so remarkable even in the active form of cirrhosis, suggesting that piece-meal necrosis might be progressed slowly and step by step. 6. Neoplasm of the liver was diagnosed in 206 cases, 134 (65.0%) being primary carcinoma and most of the remainders metastatic tumor and anaplastic carcinoma. In primary carcinoma. male was far more commonly affected than female with the ratio of 5.1 : 1 and the mean age was 48.4 year old. Histopathologically 12.5 cases (60.7%) were hepatocellular and only 7 were bile duct type of carcinoma. 7. 24 cases of primary hepatocellular carcinoma showed, as associated pathological findings, cirrhotic changes which were mostly regarded as macronodular well differentiated. Although none of the seven cholangiocarcinoma was combined with cirrhosis, three of them were associated with histologic changes usually found in clonorchiasis. 8. Of the miscellaneous liver diseases, abscess ranked the first, most of which were regarded as nonspecific. And granulation tissue, pus, or collagenous wall was the only finding frequently observable in the needle biopsied tissue from abscess. In conclusion, it can be stated that in comparison to liver diseases of Europeans and Americans, those among Koreans examined on biopsied specimens exhibited quite different incidence, which may be the result of unusually high occurence of primary carcinoula of the liver, and that clonorchiasis, a common disease among Koreans, is closely related to the cholangiocarcinoma, and that the elevation of serum transaminase may be used for the clinical activity of liver cirrhosis.

Original Articles

A Cytopathologic Analysis of Percutaneous Transthoracic Needle Aspiration Cytology of the Lung: A Six-year Correlation Study in 322 Cases.: Sook Kim, Dong Won Kim, So Young Jin, Dong Wha Lee; Korean J Cytopathol. 1995;6(2):140-147.

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Abstract PDF: In a six-year period (from May 1988 to April 1994), fine needle aspiration cytology (FNAC) of 322 pulmonary lesions from 296 patients were performed at Soonchunhyang University Hospital. Of these 322, malignancy was diagnosed cytologically in 139 (43.2%), suspicious malignancy in 7 (2.2%), negative in 164 (50.8%), and insufficient material in 12 (3.8%). Malignant lesion consisted of 54 cases of adenocarcinoma, 50 cases of squamous cell carcinoma, 18 cases of small cell carcinoma. They were verified by histologic confirmation in 70 cases. There were 2 (0.6%) false positive cases due to florid bronchoalveolar hyperplasia and atypical bronchial epithelial cells associated with granulomatous lesion. Overall accuracy rate was 90%, the sensitivity 84.3% and the specificity 94.7%.

Urinary Cytologic Findings of Transitional Cell Carcinoma: Analysis of 83 Cases.: Yeon Mee Kim, Hye Je Cho; Korean J Cytopathol. 1995;6(2):148-155.

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Abstract PDF: Urinary cytology has become an essential element in the diagnosis and management of transitional cell carcinoma(TCC) of the urinary tract. It has the advantage of being noninvasive, inexpensive, and easily accessible. Besides that it can even detect malignancy when unsuspected at cystoscopy. We report a retrospective review of urine cytology in the diagnosis of 83 TCC cases that underwent 295 cytologic evaluation. All patients had biopsy-proven TCC of the bladder, ureter and renal pelvis. The overall incidence of the positive cytology cases was 66.2%. To define the cytologic features of tumor cells, we tried to use three cytologic gradings such as "grade 1", "grade 2", and "grade 3" according to the cytologic degree of anaplastic neoplastic cells. These cytologic gades of TCC were relatively well correlated with the histologic grade and tumor invasiveness. This result suggests that the recognition of characteristic cellular features of TCC can suspect the histologic grade and tumor stage. The false negative TCC cases were 78.9%. They showed severe inflammatory or bloody background and a few neoplastic cells. Therefore, a cautious approach for accurate interpretation, personal experience, and proper fixation and processing could expand the role of urinary cytology.

Etc

Congenital Acute Myelocytie Leukemia -Report of An Autopsy Case Associated with Mongolism-: Hyun Sook Chi, Jung Bin Lee, Yong Il Kim, Sang In Kim, Hark Jin Chang*, Sang Woo Kim*, Chang Yee Hong*; Korean J Cytopathol. 1972;6(2):149-154.

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Abstract: An autopsy case of congenital acute myelocytic leukemia in a twelve day-old mongoloid male neonate is presented and discussed with brief literature review. It is assumed that this is a first proven and documented case in the Korean literature.

Original Article

Fine Needle Aspiration Cytologic Findings of Inflammatory Breast Diseases.: Hye Kyoung Yoon, Seol Mi Park, Mi Sun Kang, Young Il Yang, Chan Hwan Kim; Korean J Cytopathol. 1995;6(2):156-162.

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Abstract PDF: Fine needle aspiration of the breast is an important diagnostic tool in malignant lesions, but is also useful in differentiation of inflammatory breast diseases mimicking carcinoma clinically and radiologically. Recently. the authors have experienced eight biopsy-proven cases of chronic inflammatory diseases of the breast, which consisted of 4 cases of duct ectasia, 2 cases of fat necrosis, and a case of tuberculous mastitis and granulomatous mastitis respectively, Their cytologic features mainly based on the components and the relative frequency of inflammatory cells were evaluated for differential diagnosis of chronic inflammatory breast diseases. The results are as follows: 1. In cases of duct ectasia, varying amount of neutrophils, mononuclear leukocytes, histiocytes and multinucleated giant cells were intermixed with benign epithelial cell clusters. 2. Abundant fat tissue fragments were diagnostic for fat necrosis. Histiocytes and mononuclear cells were main components but not rich, and neutrophils and giant cells were infrequently observed. 3. Characteristic granulomas composed of epithelioid cells, mononuclear leukocytes and Langhans} type giant cells and lymphocytic infiltrates were conspicuous in tuberculous mastitis, and occasionally neutrophils, necrotic materials and epithelial cell clusters were found. 4. In granulomatous mastitis, epithelioid cell granulomas were also noted but numerous neutrophils and histiocytes were intermingled within or outside the granulomas.

Etc

A Histopathological Study on Tumors of Central Nervous System: Hyun Soon Lee, Eui Keun Ham, Jong Man Kim, Sang Kook Lee; Korean J Cytopathol. 1972;6(2):157-167.

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Abstract: A histopathological study on tumors of central nervous system among Koreans was made of one hundred twenty cases of surgical material, obtained during a period of 10 years, 1962-1971, at the Department of Pathology, College of Medicine, Seoul National University, and followings are results; 1. Out of 89 cases, 45 male and 44 female, of intracranial tumors examined, 49 cases of them were benign and 40 malignant. Ages of the cases ranged from 6 months (retinoblastoma) to 65 years (primary intracranial sarcoma). 2. The highest incidence of histological type, out of intracranial tumors, was glioma (33.7%), even including astrocytoma (25.9%) in the high order of frequency in incidence. Average age incidences among the gliomas, were located in 24 years of low grade of astrocytoma, 26.1 years of glioblastoma multiforme and 28.3 years of ependymoma. And also encountered in most of them were no significant sex differences in their incidences, while in cases of glioblastoma multiforme male was more frequently affected with ratio of 8 : 3, than female. 3. Site distribution in various age groups showed anterior and middle fossas of intracranial cavity to be involved by 53 cases of intracranial tumors and 23 tumors in the posterior intracranial fossa, and the others 13 cases. Out of anterior and middle fossa tumors, incidences of histological type of tumors in 0-20 years age group were highest in astrocytomas and highest both 20-40 and over 40 years age groups in meningiomas. And out of posterior fossa tumors were highest incidences of 0-20 years age group both in meduloblastoma and astrocytoma and both 20-40 and over 40 years age groups in intracranial neurilemoma. 4. Out of 31 intraspinal tumors, incidence of histological type were high in neurilemoma (61%), thereafter astrocytoma (16%) and meningioma (13%), in orders of frequency. And out of them, site distribution showed thoracic portion to be involved 48%, in lumbar 19%, cervical 16%, sacral 10% and multiple levels 7%, respectively. 5. In this study on tumors of central nervous system, authors intended to observe retinoblastomas, pituitary tumors and even metastatic tumors, together with usual cerebro-spinal tumors. They were briefly discussed concerning with their onchogenesis in embryological aspect.

Case Report

Effusion Cytology of Ki - 1 Positive Anaplastic Large Cell Lymphoma: A Case Report.: Mi Sook Lee, Mi Ja Lee, Yu Kyung Jeong, Sung Chul Lim, Keun Hong Kee, Ho Jong Jeon; Korean J Cytopathol. 1995;6(2):163-168.

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Abstract PDF: Ki-1 positive anaplastic large cell lymphoma is a newly described high-grade lymphoma and is defined by histopathological and immunologic criteria. We experienced a case of systemically involving Ki-1 positive anaplastic large cell lymphoma in a 44 year-old female which initially manifested as pleural effusion. Abdominopelvic CT scan showed the evidence of marked lymphadenopathy in retroperitoneal and both external and inguinal lymph nodes. On cytologic examination of pleural fluid tumor cells revealed pleomorphic large isolated cells with prominent nucleoli and abundant cytoplasms. The nuclei were large with irregular profiles including some deep invaginations. Also. occasional multilobed/multinucleated and binucleated nuclei were seen. Immunohistochemical examination was performed to differentiate from the undifferentiated adenocarcinoma. Hodgkin's disease, non-Hodgkin's lymphoma and malignant histiocytosis. The neoplastic cells were positive for leukocyte common antigen. CD3 CD30(ki-1) but negative for cytokeratin. epithelial membrane antigen. and CD15. A histologic diagnosis of Ki-1 positive anaplastic lymphoma was made by biopsies of the inguinal lymph node, polypoid lesion of the stomach and cecum.

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