Journal of Pathology and Translational Medicine

Original Articles

Clinicopathological Study of 18 Cases of Inflammatory Myofibroblastic Tumors with Reference to ALK-1 Expression: 5-Year Experience in a Tertiary Care Center: Ramesh Babu Telugu, Anne Jennifer Prabhu, Nobin Babu Kalappurayil, John Mathai, Birla Roy Gnanamuthu, Marie Therese Manipadam; J Pathol Transl Med. 2017;51(3):255-263. Published online April 17, 2017; DOI: https://doi.org/10.4132/jptm.2017.01.12

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Background
Inflammatory myofibroblastic tumor is a histopathologically distinctive neoplasm of children and young adults. According to World Health Organization (WHO) classification, inflammatory myofibroblastic tumor is an intermediate-grade tumor, with potential for recurrence and rare metastasis. There are no definite histopathologic, molecular, or cytogenetic features to predict malignant transformation, recurrence, or metastasis.
Methods
A 5-year retrospective study of histopathologically diagnosed inflammatory myofibroblastic tumors of various anatomic sites was conducted to correlate anaplastic lymphoma kinase-1 (ALK-1) expression with histological atypia, multicentric origin of tumor, recurrence, and metastasis. Clinical details of all the cases were noted from the clinical work station. Immunohistochemical stains for ALK-1 and other antibodies were performed. Statistical analysis was done using Fisher exact test.
Results
A total of 18 cases of inflammatory myofibroblastic tumors were found during the study period, of which 14 were classical. The female-male ratio was 1:1 and the mean age was 23.8 years. Histologically atypical (four cases) and multifocal tumors (three cases, multicentric in origin) were noted. Recurrence was noted in 30% of ALK-1 positive and 37.5% of ALK-1 negative cases, whereas metastasis to the lung, liver, and pelvic bone was noted in the ALK-1 positive group only.
Conclusions
Overall, ALK-1 protein was expressed in 55.6% of inflammatory myofibroblastic tumors. There was no statistically significant correlation between ALK-1 expression, tumor type, recurrence and metastasis. However, ALK-1 immunohistochemistry is a useful diagnostic aid in the appropriate clinical and histomorphologic context.

Citations

Citations to this article as recorded by

Treatment and outcomes in pediatric inflammatory myofibroblastic tumors – A systematic review of published studies
Arimatias Raitio, Paul D. Losty
European Journal of Surgical Oncology.2024; 50(7): 108388. CrossRef
Case report: Epithelioid inflammatory myofibroblastic sarcoma treated with an ALK TKI ensartinib
Mengmeng Li, Ruyue Xing, Jiuyan Huang, Chao Shi, Chunhua Wei, Huijuan Wang
Frontiers in Oncology.2023;[Epub] CrossRef
Inflammatory Myofibroblastic Tumour of the Sinonasal Tract with Orbital and Intracranial Extensions Simulating a Malignancy: A Case Report and Review of Literature
Gaveshani Mantri, Subhalaxmi Rautray, Rahul Mohanty, Vinushree Karakkandy
Indian Journal of Otolaryngology and Head & Neck Surgery.2022; 74(S2): 1668. CrossRef
Clinical, pathologic, and molecular features of inflammatory myofibroblastic tumors in children and adolescents
Aurore Pire, Daniel Orbach, Louise Galmiche, Dominique Berrebi, Sabine Irtan, Sabah Boudjemaa, Hervé J. Brisse, Laureline Berteloot, Salma Moalla, Charlotte Mussini, Pascale Philippe‐Chomette, Bogdana Tilea, Gaelle Pierron, Florent Guerin, Véronique Minar
Pediatric Blood & Cancer.2022;[Epub] CrossRef
Case Report: Early Distant Metastatic Inflammatory Myofibroblastic Tumor Harboring EML4-ALK Fusion Gene: Study of Two Typical Cases and Review of Literature
Qianqian Han, Xin He, Lijuan Cui, Yan Qiu, Yuli Li, Huijiao Chen, Hongying Zhang
Frontiers in Medicine.2022;[Epub] CrossRef
Inflammatory myofibroblastic tumor: Amulti‐institutionalstudy from the Pediatric Surgical Oncology Research Collaborative
Barrie S. Rich, Joanna Fishbein, Timothy Lautz, Nathan S. Rubalcava, Tanvi Kartal, Erika Newman, Pei En Wok, Rodrigo L. P. Romao, Richard Whitlock, Bindi Naik‐Mathuria, Stephanie F. Polites, Katrine Løfberg, Danny Lascano, Eugene Kim, Jacob Davidson, Andr
International Journal of Cancer.2022; 151(7): 1059. CrossRef
Child inflammatory myofibroblastic tumor of the kidney misdiagnosed as Wilms' tumor: case report
Yu-Feng Bai, Jing-Zhong Liu, Li-Na Yue, Li Chen, Sui-Yi Liu, Rui Liu
Radiology Case Reports.2022; 17(12): 4920. CrossRef
A Common Cell of Origin for Inflammatory Myofibroblastic Tumor and Lung Adenocarcinoma with ALK rearrangement
Vasyl Nesteryuk, Omar Hamdani, Raymond Gong, Nava Almog, Brian M. Alexander, Steffan Soosman, Ken Yoneda, Siraj M. Ali, Alexander D. Borowsky, Jonathan W. Riess
Clinical Lung Cancer.2022; 23(8): e550. CrossRef
An extremely rare case of malignant jejunal mesenteric inflammatory myofibroblastic tumor in a 61-year-old male patient: A case report and literature review
Hamdi Al Shenawi, Salamah A. Al-Shaibani, Suhair K. Al Saad, Fedaa Al-Sindi, Khalid Al-Sindi, Noor Al Shenawi, Yahya Naguib, Rami Yaghan
Frontiers in Medicine.2022;[Epub] CrossRef
Primary inflammatory myofibroblastic tumor of stomach—report of a very rare case
Ranendra Hajong, Kewithinwangbo Newme, Donkupar Khongwar
Journal of Family Medicine and Primary Care.2021; 10(1): 552. CrossRef
Complicated course of biliary inflammatory myofibroblastic tumor mimicking hilar cholangiocarcinoma: A case report and literature review
Sandra Strainiene, Kotryna Sedleckaite, Juozas Jarasunas, Ilona Savlan, Juozas Stanaitis, Ieva Stundiene, Tomas Strainys, Valentina Liakina, Jonas Valantinas
World Journal of Clinical Cases.2021; 9(21): 6155. CrossRef
Epithelioid Inflammatory Myofibroblastic Sarcoma Presenting as Gastrointestinal Bleed: Case Report and Literature Review
Alexandra Giannaki, Dimitrios Doganis, Panagiota Giamarelou, Anastasia Konidari
JPGN Reports.2021; 2(1): e019. CrossRef
Complete response to alectinib following crizotinib in an ALK-positive inflammatory myofibroblastic tumor with CNS involvement
Camila B. Xavier, Felipe S.N.A. Canedo, Fabíola A.S. Lima, Raíssa R. Melo, Luiz Guilherme C.A. Lima, José Flávio G. Marin, Ciro E. Souza, Olavo Feher
Current Problems in Cancer: Case Reports.2021; 4: 100117. CrossRef
Urinary Bladder Inflammatory Myofibroblastic Tumor With Mutated TP53 and PPFIBP1-ALK Gene Fusion
Andreia N. Barbieri, Christopher T. Tallman, Raj Satkunasivam, Joseph Annunziata, Jessica S. Thomas, Randall J. Olsen, Steven S. Shen, Michael J. Thrall, Mary R. Schwartz
AJSP: Reviews and Reports.2021; 26(1): 45. CrossRef
Therapeutic options in inoperable ROS1-rearranged inflammatory myofibroblastic tumor of the tongue in a child: a case report and literature review
Malgorzata Styczewska, Agastya Patel, Joanna Jaskulowska, Jan Godzinski, Dominik Swieton, Bartosz Wasag, Juliea Dass, Ewa Bien, Malgorzata A. Krawczyk
Anti-Cancer Drugs.2021; 32(10): 1111. CrossRef
Non-squamous cell carcinoma diseases of the larynx: clinical and imaging findings
Serap Doğan, Alperen Vural, Güven Kahriman, Hakan İmamoğlu, Ümmühan Abdülrezzak, Mustafa Öztürk
Brazilian Journal of Otorhinolaryngology.2020; 86(4): 468. CrossRef
Successful treatment of pulmonary inflammatory myofibroblastic tumor with platinum‐pemetrexed: The first report of two cases
Xiaoyan Si, Hanping Wang, Xiaotong Zhang, Mengzhao Wang, Yan You, Li Zhang
Thoracic Cancer.2020; 11(8): 2339. CrossRef
Rare presentation of inflammatory myofibroblastic tumor in the kidney
Hiba Abduljawad, Ahmet Aslan, Khalifa Aldoseri, Erdem Yilmaz, Wael Ibrahim
Radiology Case Reports.2020; 15(8): 1266. CrossRef
Histopathological landscape of rare oesophageal neoplasms
Gianluca Businello, Carlo Alberto Dal Pozzo, Marta Sbaraglia, Luca Mastracci, Massimo Milione, Luca Saragoni, Federica Grillo, Paola Parente, Andrea Remo, Elena Bellan, Rocco Cappellesso, Gianmaria Pennelli, Mauro Michelotto, Matteo Fassan
World Journal of Gastroenterology.2020; 26(27): 3865. CrossRef
Laryngeal Inflammatory Myofibroblastic Tumor : Case Series and Literature Review
Ki-Ik Park, Sung-hoon Kim, In-Suh Park, Ji Won Kim
Journal of The Korean Society of Laryngology, Phoniatrics and Logopedics.2019; 30(1): 57. CrossRef
Anaplastic lymphoma kinase-negative pulmonary inflammatory myofibroblastic tumor with multiple metastases and its treatment by Apatinib
Qiuxia Liu, Jianguo Wei, Xizhong Liu, Jianfang Wang
Medicine.2019; 98(52): e18414. CrossRef
Inflammatory myofibroblastic tumor
Veronika Marcináková, Hana Dittrichová, Karel Franěk, Pavel Hanek
Urologie pro praxi.2019; 20(1): 40. CrossRef
Ureteral inflammatory myofibroblastic tumor
Faping Li, Hui Guo, Heping Qiu, Yuchuan Hou
Medicine.2018; 97(46): e13177. CrossRef
Pulmonary inflammatory myofibroblastic tumour misdiagnosed as a round pneumonia
Samira Naime, Anjum Bandarkar, Gustavo Nino, Geovanny Perez
BMJ Case Reports.2018; : bcr-2017-224091. CrossRef

Morphometric Analysis of Thyroid Follicular Cells with Atypia of Undetermined Significance: Youngjin Kang, Yoo Jin Lee, Jiyoon Jung, Youngseok Lee, Nam Hee Won, Yang Seok Chae; J Pathol Transl Med. 2016;50(4):287-293. Published online June 13, 2016; DOI: https://doi.org/10.4132/jptm.2016.04.04

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Abstract PDF

Background
Atypia of undetermined significance (AUS) is a category that encompasses a heterogeneous group of thyroid aspiration cytology. It has been reclassified into two subgroups based on the cytomorphologic features: AUS with cytologic atypia and AUS with architectural atypia. The nuclear characteristics of AUS with cytologic atypia need to be clarified by comparing to those observed in Hashimoto thyroiditis and benign follicular lesions.
Methods
We selected 84 cases of AUS with histologic follow-up, 24 cases of Hashimoto thyroiditis, and 26 cases of benign follicular lesions. We also subcategorized the AUS group according to the follow-up biopsy results into a papillary carcinoma group and a nodular hyperplasia group. The differences in morphometric parameters, including the nuclear areas and perimeters, were compared between these groups.
Results
The AUS group had significantly smaller nuclear areas than the Hashimoto thyroiditis group, but the nuclear perimeters were not statistically different. The AUS group also had significantly smaller nuclear areas than the benign follicular lesion group; however, the AUS group had significantly longer nuclear perimeters. The nuclear areas in the papillary carcinoma group were significantly smaller than those in the nodular hyperplasia group; however, the nuclear perimeters were not statistically different.
Conclusions
We found the AUS group to be a heterogeneous entity, including histologic follow-up diagnoses of papillary carcinoma and nodular hyperplasia. The AUS group showed significantly greater nuclear irregularities than the other two groups. Utilizing these features, nuclear morphometry could lead to improvements in the accuracy of the subjective diagnoses made with thyroid aspiration cytology.

Citations

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Meta-analysis on the utility of morphometry in the cytological differential diagnosis of thyroid neoplasms
Prema Saldanha
MGM Journal of Medical Sciences.2024; 11(1): 49. CrossRef
Gray zone Bethesda category III – Atypia of undetermined significance lesions of the thyroid: Potential diagnostic issues and image morphometry as a useful adjunct to cytomorphology
Tarunpreet Saini, Reetu Kundu, Manish Rohilla, Parikshaa Gupta, Nalini Gupta, Radhika Srinivasan, Uma Nahar Saikia, Pranab Dey
Cytojournal.2024; 21: 38. CrossRef
Morphometric study in thyroid tumors
Iuliana Mohorea, Bogdan Socea, Alexandru Carâp, Dragoș Șerban, Zenaida Ceaușu, Mihail Ceaușu
Experimental and Therapeutic Medicine.2023;[Epub] CrossRef
The Usefulness of Immunocytochemistry of CD56 in Determining Malignancy from Indeterminate Thyroid Fine-Needle Aspiration Cytology
Hyunseo Cha, Ju Yeon Pyo, Soon Won Hong
Journal of Pathology and Translational Medicine.2018; 52(6): 404. CrossRef

Core Needle Biopsy Is a More Conclusive Follow-up Method Than Repeat Fine Needle Aspiration for Thyroid Nodules with Initially Inconclusive Results: A Systematic Review and Meta-Analysis: Jung-Soo Pyo, Jin Hee Sohn, Guhyun Kang; J Pathol Transl Med. 2016;50(3):217-224. Published online April 14, 2016; DOI: https://doi.org/10.4132/jptm.2016.02.15

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Abstract PDF

Background
This study investigated the appropriate management of thyroid nodules with prior non-diagnostic or atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) through a systematic review and meta-analysis.
Methods
This study included 4,235 thyroid nodules from 26 eligible studies. We investigated the conclusive rate of follow-up core needle biopsy (CNB) or repeat fine needle aspiration (rFNA) after initial fine needle aspiration (FNA) with non-diagnostic or AUS/FLUS results. A diagnostic test accuracy (DTA) review was performed to determine the diagnostic role of the follow-up CNB and to calculate the area under the curve (AUC) on the summary receiver operating characteristic (SROC) curve.
Results
The conclusive rates of follow-up CNB and rFNA after initial FNA were 0.879 (95% confidence interval [CI], 0.801 to 0.929) and 0.684 (95% CI, 0.627 to 0.736), respectively. In comparison of the odds ratios of CNB and rFNA, CNB had more frequent conclusive results than rFNA (odds ratio, 5.707; 95% CI, 2.530 to 12.875). Upon subgroup analysis, follow-up CNB showed a higher conclusive rate than rFNA in both initial non-diagnostic and AUS/FLUS subgroups. In DTA review of followup CNB, the pooled sensitivity and specificity were 0.94 (95% CI, 0.88 to 0.97) and 0.88 (95% CI, 0.84 to 0.91), respectively. The AUC for the SROC curve was 0.981, nearing 1.
Conclusions
Our results show that CNB has a higher conclusive rate than rFNA when the initial FNA produced inconclusive results. Further prospective studies with more detailed criteria are necessary before follow-up CNB can be applied in daily practice.

Citations

Citations to this article as recorded by

Fine Needle Aspiration Cytology vs. Core Needle Biopsy for Thyroid Nodules: A Prospective, Experimental Study Using Surgical Specimen
Hyuk Kwon, Jandee Lee, Soon Won Hong, Hyeong Ju Kwon, Jin Young Kwak, Jung Hyun Yoon
Journal of the Korean Society of Radiology.2022; 83(3): 645. CrossRef
Comparison of Core Needle Biopsy and Repeat Fine-Needle Aspiration in Avoiding Diagnostic Surgery for Thyroid Nodules Initially Diagnosed as Atypia/Follicular Lesion of Undetermined Significance
Leehi Joo, Dong Gyu Na, Ji-hoon Kim, Hyobin Seo
Korean Journal of Radiology.2022; 23(2): 280. CrossRef
Diagnostic performance of core needle biopsy as a first‐line diagnostic tool for thyroid nodules according to ultrasound patterns: Comparison with fine needle aspiration using propensity score matching analysis
Hye Shin Ahn, Inyoung Youn, Dong Gyu Na, Soo Jin Kim, Mi Yeon Lee
Clinical Endocrinology.2021; 94(3): 494. CrossRef
Usage and Diagnostic Yield of Fine-Needle Aspiration Cytology and Core Needle Biopsy in Thyroid Nodules: A Systematic Review and Meta-Analysis of Literature Published by Korean Authors
Soon-Hyun Ahn
Clinical and Experimental Otorhinolaryngology.2021; 14(1): 116. CrossRef
2021 Korean Thyroid Imaging Reporting and Data System and Imaging-Based Management of Thyroid Nodules: Korean Society of Thyroid Radiology Consensus Statement and Recommendations
Eun Ju Ha, Sae Rom Chung, Dong Gyu Na, Hye Shin Ahn, Jin Chung, Ji Ye Lee, Jeong Seon Park, Roh-Eul Yoo, Jung Hwan Baek, Sun Mi Baek, Seong Whi Cho, Yoon Jung Choi, Soo Yeon Hahn, So Lyung Jung, Ji-hoon Kim, Seul Kee Kim, Soo Jin Kim, Chang Yoon Lee, Ho K
Korean Journal of Radiology.2021; 22(12): 2094. CrossRef
Malignancy rate of Bethesda category III thyroid nodules according to ultrasound risk stratification system and cytological subtype
Won Sang Yoo, Hwa Young Ahn, Hye Shin Ahn, Yun Jae Chung, Hee Sung Kim, Bo Youn Cho, Mirinae Seo, Jae Hoon Moon, Young Joo Park
Medicine.2020; 99(2): e18780. CrossRef
2019 Practice guidelines for thyroid core needle biopsy: a report of the Clinical Practice Guidelines Development Committee of the Korean Thyroid Association
Chan Kwon Jung, Jung Hwan Baek, Dong Gyu Na, Young Lyun Oh, Ka Hee Yi, Ho-Cheol Kang
Journal of Pathology and Translational Medicine.2020; 54(1): 64. CrossRef
Laser Ablation Versus Radiofrequency Ablation for Benign Non-Functioning Thyroid Nodules: Six-Month Results of a Randomized, Parallel, Open-Label, Trial (LARA Trial)
Roberto Cesareo, Claudio Maurizio Pacella, Valerio Pasqualini, Giuseppe Campagna, Mario Iozzino, Andrea Gallo, Angelo Lauria Pantano, Roberto Cianni, Claudio Pedone, Paolo Pozzilli, Chiara Taffon, Anna Crescenzi, Silvia Manfrini, Andrea Palermo
Thyroid.2020; 30(6): 847. CrossRef
Diagnostic Efficacy and Safety of Core Needle Biopsy as a First-Line Diagnostic Method for Thyroid Nodules: A Prospective Cohort Study
Min Ji Hong, Dong Gyu Na, Hunkyung Lee
Thyroid.2020; 30(8): 1141. CrossRef
Is thyroid core needle biopsy a valid compliment to fine-needle aspiration?
Liron Pantanowitz, Lester D.R. Thompson, Xin Jing, Esther Diana Rossi
Journal of the American Society of Cytopathology.2020; 9(5): 383. CrossRef
A Monocentric Retrospective Study about the Correlation between Histology and Cytology of Thyroid Indeterminate Nodules Classified as TIR 3A and TIR 3B, according to 2014 Italian Consensus for Classification and Reporting of Thyroid Cytology
Francesco Quaglino, Giulia Arnulfo, Sergio Sandrucci, Claudio Rossi, Valentina Marchese, Roberto Saracco, Stefano Guzzetti, Stefano Taraglio, Enrico Mazza
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Nuclear features of papillary thyroid carcinoma: Comparison of Core needle biopsy and thyroidectomy specimens
Jae Yeon Seok, Jungsuk An, Hyun Yee Cho, Younghye Kim, Seung Yeon Ha
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Statement and Recommendations on Interventional Ultrasound as a Thyroid Diagnostic and Treatment Procedure
Christoph F. Dietrich, Thomas Müller, Jörg Bojunga, Yi Dong, Giovanni Mauri, Maija Radzina, Manjiri Dighe, Xin-Wu Cui, Frank Grünwald, Andreas Schuler, Andre Ignee, Huedayi Korkusuz
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Role of core needle biopsy as a first-line diagnostic tool for thyroid nodules: a retrospective cohort study
Min Ji Hong, Dong Gyu Na, Soo Jin Kim, Dae Sik Kim
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Core Needle Biopsy of the Thyroid: 2016 Consensus Statement and Recommendations from Korean Society of Thyroid Radiology
Dong Gyu Na, Jung Hwan Baek, So Lyung Jung, Ji-hoon Kim, Jin Yong Sung, Kyu Sun Kim, Jeong Hyun Lee, Jung Hee Shin, Yoon Jung Choi, Eun Ju Ha, Hyun Kyung Lim, Soo Jin Kim, Soo Yeon Hahn, Kwang Hwi Lee, Young Jun Choi, Inyoung Youn, Young Joong Kim, Hye Sh
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Ultrasound-guided fine needle aspiration versus core needle biopsy: comparison of post-biopsy hematoma rates and risk factors
In Hye Chae, Eun-Kyung Kim, Hee Jung Moon, Jung Hyun Yoon, Vivian Y. Park, Jin Young Kwak
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The Role of Core Needle Biopsy for Thyroid Nodules with Initially Indeterminate Results on Previous Fine-Needle Aspiration: A Systematic Review and Meta-Analysis
C.H. Suh, J.H. Baek, C. Park, Y.J. Choi, J.H. Lee
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Fine Needle Aspiration Cytology of Atypical Proliferative Lesion of the Breast.: Kun Chang Song, Kwang Gil Lee; Korean J Cytopathol. 1994;5(1):52-56.

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Abstract PDF: We experienced a case of fine-needle aspiration(FNA) cytology of breast which showed atypical proliferative lesion. It was very difficult to differentiate this case from malignancy, because of hypercellular smear and many clusters composed of large, atypical ductal cells. However, it showed other features favoring benignancy, such as tendency of cellular cohesiveness, only slightly increased nucleus/cytoplasm ratio and most importantly presence of myoepithelial cells. It's histologic diagnosis was intraductal hyperplasia with atypia. This case indicates that all atypical breast FNA specimen should lead to the suggestion of surgical biopsy for avoiding over- or under-diagnosis.

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.

Cytologic Analysis of Fibroadenomas of Breast Overdiagnosed as High Risk Group in Fine Needle Aspiration Cytology .: Sung Hye Park, Gil Sook Yoon, Misun Choi, Shin Kwang Khang; Korean J Cytopathol. 1999;10(2):127-127.

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Abstract PDF: Among total 108 cases of biopsy-proven fibroadenomas of the breast, which obtained from the files of the Asan Medical Center during one year period from October 1998 to September 1999, 23 cases cytologically diagnosed as high risk group were reviewed to retrieve the mis-leading factors. Initial cytologic diagnoses of 23 cases were proliferative breast lesion with atypia(high risk) in 21 cases(91.3%) and papillary neoplasm in 2 cases(8.7%). When we reanalysed 23 cases by Masood scoring system, they were classified as one non-proliferative breast lesion(4.3%), 16 proliferative breast lesions without atypia (69.6%), and 6 proliferative breast lesions with atypia(26.1%). None were subject to the category of carcinoma. Cytologic features leading to the overdiagnosis of high grade epithelial lesions were as follows; cellular dissociation without nuclear atypia, nuclear pleomorphism, anisonucleosis, and occasional macronucleoli without nuclear enlargement, lack of myxoid stroma, and few naked stromal cells. To avoid cytologic overdiagnosis of fibroadenoma, mild to moderate nuclear pleomorphism without nuclear enlargement, and cellular dissociation without nuclear atypia should not be regarded as criteria of high risk group.

Correlation Of Human Papillomavirus Infection and Postmenopausal Squamous Atypia in Cervical Cytology.: Yi Kyeong Chun, In Gul Moon, Sung Ran Hong, Hye Sun Kim, Jong Sun Choi, Ji Young Park, Jong Sook Park, Tae Jin Kim, Hy Sook Kim; Korean J Cytopathol. 2004;15(2):81-85.

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Abstract PDF: Postmenopausal squamous atypia (PSA) is a phenomenon characterized by cellular alterations mimicking condyloma in the uterine cervix of postmenopausal women. It is not associated with human papillomavirus (HPV) infection. The aim of this study is to correlate findings with HPV infection and the cytohistologic findings of PSA. Eighty-three smears from postmenopausal women, initially interpreted as ASCUS and low-grade squamous intraepithelial lesions(LSIL), were reviewed according to the criteria of PSA. Fifty-eight cases were subsequently reclassified as PSA. Forty cases categorized as PSA were available for HPV-DNA detection by a nested polymerase chain reaction. Eight of these 40 cases(20%) showed biopsy-proven LSIL lesions. The HPV-DNA was detected in 42.5%(17/40), compared to 25%(5/20) of control cases. The HPV-DNA detection rate of biopsy-proven LSIL was 62.5%(5/8). It has been concluded that cytologic differential diagnosis of PSA from LSIL is difficult due to because of poor histologic and viral correlation.

Comparision of Effectiveness between the ThinPrep(R) and the Cytospin Preparations of the Repeated Urine Cytology.: Soon Won Hong, Hyun Kyung Kim, Ju Yeon Pyo, Yoonhee Lee, Woo Hee Jung, Se Hoon Kim; Korean J Cytopathol. 2007;18(1):55-61.

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Abstract PDF: Once diagnosed as "cell paucity" or "atypia" by the cytospin (CS) preparation, this CS preparation does not secure a precise diagnosis by repeated testing alone. Although the ThinPrep(R) (TP) preparation is acknowledged to show increased cellularity, performing the screening tests for the cases that have enough cellularity, according to CS, raises issues for the cost-effectiveness. To obtain a more precise diagnosis through increasing the cellularity by performing TP, we selected the cases that were diagnosed as "cell paucity" or "atypia" by CS, but they required a more precise diagnosis, and the samples were processed via both CS and TP to compare the results. 11 patients diagnosed as "cell paucity" and 22 patients diagnosed as "atypia" by CS participated in this study. When the detection rate of atypical cells in both preparations with repeated urine cytology was compared, the overall detection rate of TP (16cases, 48.5%) was superior than that of CS (11cases, 33.3%), with statistical significance. The cellularity of both preparations was compared on repeated urine cytology; the general cellularity of TP (29cases, 87.9%) was higher than that of CS (20cases, 60.6%), but there was no statistical significance. Particularly, we repeated the TP for the 1 case that was diagnosed as "atypia" and we performed polyoma virus immunohistochemical staining, which confirmed polyoma virus. In conclusion, we can avoid obtaining negative diagnosis from cases with uncertain "atypia" or "cell paucity" by performing repeated TP testing.

Clinicopathologic Analysis of Gastrointestinal Polyps.: Hye Rim Park, In Sun Kim, Seung Yong Paik; Korean J Pathol. 1988;22(3):232-243.

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Abstract PDF: Pathologists play an important role in proper evaluation of endoscopically removed polyps of the gastrointestinal tract. This study is purposed to reclassify the polyps and review the clinicopathologic features of each histologic subtypes and their malignant potential. Our material consists of total 345 gastrointestinal polyps obtained from Jan. 1986 to Dec. 1987. The results are as follows: 1) A total of 345 gastrointestinal polyps was removed from stomach is 151 cases, from colon in 180 cases, and from small intestine in 14 cases. 2) Hyperplastic polyps were the most common type of polyps I stomach (53.6%) whereas neoplastic polyps were the most common in colon (56.1%). 3) Hyperplastic polyps of the stomach occur in any age after the 3rd decade of life and neoplastic polyps predominantly developed between the 5th and 8th decades. Juvenile retention polyps were frequently noted before the 3rd decade of age. 4) Approximately 267 cases (77.4%) of patients had a single polyp and the remainders had multiple polyps. The gastric polyps were usually located at the antrum and the colonic polyps were at the sigmoid colon and rectum. 5) Epithelial atypia was exclusively noted in the neoplastic polyps of stomach (72.7%) and colon (72.3%). Malignancy in the polyp was observed in the neoplastic polyps only (13 cases). 6) Different types of polyp may occur in the same organ.

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