Journal of Pathology and Translational Medicine

Original Article

A scoring system for the diagnosis of non-alcoholic steatohepatitis from liver biopsy: Kyoungbun Lee, Eun Sun Jung, Eunsil Yu, Yun Kyung Kang, Mee-Yon Cho, Joon Mee Kim, Woo Sung Moon, Jin Sook Jeong, Cheol Keun Park, Jae-Bok Park, Dae Young Kang, Jin Hee Sohn, So-Young Jin; J Pathol Transl Med. 2020;54(3):228-236. Published online April 15, 2020; DOI: https://doi.org/10.4132/jptm.2020.03.07

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Background
Liver biopsy is the essential method to diagnose non-alcoholic steatohepatitis (NASH), but histological features of NASH are too subjective to achieve reproducible diagnoses in early stages of disease. We aimed to identify the key histological features of NASH and devise a scoring model for diagnosis.
Methods
Thirteen pathologists blindly assessed 12 histological factors and final histological diagnoses (‘not-NASH,’ ‘borderline,’ and ‘NASH’) of 31 liver biopsies that were diagnosed as non-alcoholic fatty liver disease (NAFLD) or NASH before and after consensus. The main histological parameters to diagnose NASH were selected based on histological diagnoses and the diagnostic accuracy and agreement of 12 scoring models were compared for final diagnosis and the NAFLD Activity Score (NAS) system.
Results
Inter-observer agreement of final diagnosis was fair (κ = 0.25) before consensus and slightly improved after consensus (κ = 0.33). Steatosis at more than 5% was the essential parameter for diagnosis. Major diagnostic factors for diagnosis were fibrosis except 1C grade and presence of ballooned cells. Minor diagnostic factors were lobular inflammation ( ≥ 2 foci/ × 200 field), microgranuloma, and glycogenated nuclei. All 12 models showed higher inter-observer agreement rates than NAS and post-consensus diagnosis (κ = 0.52–0.69 vs. 0.33). Considering the reproducibility of factors and practicability of the model, summation of the scores of major (× 2) and minor factors may be used for the practical diagnosis of NASH.
Conclusions
A scoring system for the diagnosis of NAFLD would be helpful as guidelines for pathologists and clinicians by improving the reproducibility of histological diagnosis of NAFLD.

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Review

Standardized Pathology Report for Colorectal Cancer, 2nd Edition: Baek-hui Kim, Joon Mee Kim, Gyeong Hoon Kang, Hee Jin Chang, Dong Wook Kang, Jung Ho Kim, Jeong Mo Bae, An Na Seo, Ho Sung Park, Yun Kyung Kang, Kyung-Hwa Lee, Mee Yon Cho, In-Gu Do, Hye Seung Lee, Hee Kyung Chang, Do Youn Park, Hyo Jeong Kang, Jin Hee Sohn, Mee Soo Chang, Eun Sun Jung, So-Young Jin, Eunsil Yu, Hye Seung Han, Youn Wha Kim; J Pathol Transl Med. 2020;54(1):1-19. Published online November 13, 2019; DOI: https://doi.org/10.4132/jptm.2019.09.28

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Abstract PDF Supplementary Material

The first edition of the ‘Standardized Pathology Report for Colorectal Cancer,’ which was developed by the Gastrointestinal Pathology Study Group (GIP) of the Korean Society of Pathologists, was published 13 years ago. Meanwhile, there have been many changes in the pathologic diagnosis of colorectal cancer (CRC), pathologic findings included in the pathology report, and immunohistochemical and molecular pathology required for the diagnosis and treatment of colorectal cancer. In order to reflect these changes, we (GIP) decided to make the second edition of the report. The purpose of this standardized pathology report is to provide a practical protocol for Korean pathologists, which could help diagnose and treat CRC patients. This report consists of “standard data elements” and “conditional data elements.” Basic pathologic findings and parts necessary for prognostication of CRC patients are classified as “standard data elements,” while other prognostic factors and factors related to adjuvant therapy are classified as “conditional data elements” so that each institution could select the contents according to the characteristics of the institution. The Korean version is also provided separately so that Korean pathologists can easily understand and use this report. We hope that this report will be helpful in the daily practice of CRC diagnosis.

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Original Article

KRAS Mutation Test in Korean Patients with Colorectal Carcinomas: A Methodological Comparison between Sanger Sequencing and a Real-Time PCR-Based Assay: Sung Hak Lee, Arthur Minwoo Chung, Ahwon Lee, Woo Jin Oh, Yeong Jin Choi, Youn-Soo Lee, Eun Sun Jung; J Pathol Transl Med. 2017;51(1):24-31. Published online December 25, 2016; DOI: https://doi.org/10.4132/jptm.2016.10.03

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Abstract PDF Supplementary Material

Background
Mutations in the KRAS gene have been identified in approximately 50% of colorectal cancers (CRCs). KRAS mutations are well established biomarkers in anti–epidermal growth factor receptor therapy. Therefore, assessment of KRAS mutations is needed in CRC patients to ensure appropriate treatment.
Methods
We compared the analytical performance of the cobas test to Sanger sequencing in 264 CRC cases. In addition, discordant specimens were evaluated by 454 pyrosequencing.
Results
KRAS mutations for codons 12/13 were detected in 43.2% of cases (114/264) by Sanger sequencing. Of 257 evaluable specimens for comparison, KRAS mutations were detected in 112 cases (43.6%) by Sanger sequencing and 118 cases (45.9%) by the cobas test. Concordance between the cobas test and Sanger sequencing for each lot was 93.8% positive percent agreement (PPA) and 91.0% negative percent agreement (NPA) for codons 12/13. Results from the cobas test and Sanger sequencing were discordant for 20 cases (7.8%). Twenty discrepant cases were subsequently subjected to 454 pyrosequencing. After comprehensive analysis of the results from combined Sanger sequencing–454 pyrosequencing and the cobas test, PPA was 97.5% and NPA was 100%.
Conclusions
The cobas test is an accurate and sensitive test for detecting KRAS-activating mutations and has analytical power equivalent to Sanger sequencing. Prescreening using the cobas test with subsequent application of Sanger sequencing is the best strategy for routine detection of KRAS mutations in CRC.

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Brief Case Report

Human Papillomavirus Infection–Associated Adenoid Cystic Carcinoma of the Hard Palate: Arthur Minwoo Chung, Dong Il Sun, Eun Sun Jung, Youn Soo Lee; J Pathol Transl Med. 2017;51(3):329-331. Published online December 5, 2016; DOI: https://doi.org/10.4132/jptm.2016.07.07

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Adenoid Cystic Carcinoma of the Skull Base: Response to Radiation Therapy and Outcomes in a Retrospective Case Series
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Original Articles

Interobserver Agreement on Pathologic Features of Liver Biopsy Tissue in Patients with Nonalcoholic Fatty Liver Disease: Eun Sun Jung, Kyoungbun Lee, Eunsil Yu, Yun Kyung Kang, Mee-Yon Cho, Joon Mee Kim, Woo Sung Moon, Jin Sook Jeong, Cheol Keun Park, Jae-Bok Park, Dae Young Kang, Jin Hee Sohn, So-Young Jin; J Pathol Transl Med. 2016;50(3):190-196. Published online April 18, 2016; DOI: https://doi.org/10.4132/jptm.2016.03.01

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Abstract PDF

Background
The histomorphologic criteria for the pathological features of liver tissue from patients with non-alcoholic fatty liver disease (NAFLD) remain subjective, causing confusion among pathologists and clinicians. In this report, we studied interobserver agreement of NAFLD pathologic features and analyzed causes of disagreement.
Methods
Thirty-one cases of clinicopathologically diagnosed NAFLD from 10 hospitals were selected. One hematoxylin and eosin and one Masson’s trichrome-stained virtual slide from each case were blindly reviewed with regard to 12 histological parameters by 13 pathologists in a gastrointestinal study group of the Korean Society of Pathologists. After the first review, we analyzed the causes of disagreement and defined detailed morphological criteria. The glass slides from each case were reviewed a second time after a consensus meeting. The degree of interobserver agreement was determined by multi-rater kappa statistics.
Results
Kappa values of the first review ranged from 0.0091–0.7618. Acidophilic bodies (k = 0.7618) and portal inflammation (k = 0.5914) showed high levels of agreement, whereas microgranuloma (k = 0.0984) and microvesicular fatty change (k = 0.0091) showed low levels of agreement. After the second review, the kappa values of the four major pathological features increased from 0.3830 to 0.5638 for steatosis grade, from 0.1398 to 0.2815 for lobular inflammation, from 0.1923 to 0.3362 for ballooning degeneration, and from 0.3303 to 0.4664 for fibrosis.
Conclusions
More detailed histomorphological criteria must be defined for correct diagnosis and high interobserver agreement of NAFLD.

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JGH Open.2020; 4(3): 497. CrossRef
Obeticholic acid for the treatment of nonalcoholic steatohepatitis: Expectations and concerns
Stergios A. Polyzos, Jannis Kountouras, Christos S. Mantzoros
Metabolism.2020; 104: 154144. CrossRef
A scoring system for the diagnosis of non-alcoholic steatohepatitis from liver biopsy
Kyoungbun Lee, Eun Sun Jung, Eunsil Yu, Yun Kyung Kang, Mee-Yon Cho, Joon Mee Kim, Woo Sung Moon, Jin Sook Jeong, Cheol Keun Park, Jae-Bok Park, Dae Young Kang, Jin Hee Sohn, So-Young Jin
Journal of Pathology and Translational Medicine.2020; 54(3): 228. CrossRef
An Improved qFibrosis Algorithm for Precise Screening and Enrollment into Non-Alcoholic Steatohepatitis (NASH) Clinical Trials
Wei-Qiang Leow, Pierre Bedossa, Feng Liu, Lai Wei, Kiat-Hon Lim, Wei-Keat Wan, Yayun Ren, Jason Pik-Eu Chang, Chee-Kiat Tan, Aileen Wee, George Boon-Bee Goh
Diagnostics.2020; 10(9): 643. CrossRef
Deep learning quantification of percent steatosis in donor liver biopsy frozen sections
Lulu Sun, Jon N. Marsh, Matthew K. Matlock, Ling Chen, Joseph P. Gaut, Elizabeth M. Brunt, S. Joshua Swamidass, Ta-Chiang Liu
EBioMedicine.2020; 60: 103029. CrossRef
Magnetic resonance elastography SE-EPI vs GRE sequences at 3T in a pediatric population with liver disease
Juan S. Calle-Toro, Suraj D. Serai, Erum A. Hartung, David J. Goldberg, Bradley D. Bolster, Kassa Darge, Sudha A. Anupindi
Abdominal Radiology.2019; 44(3): 894. CrossRef
R2 relaxometry based MR imaging for estimation of liver iron content: A comparison between two methods
Juan S. Calle-Toro, Christian A. Barrera, Dmitry Khrichenko, Hansel J. Otero, Suraj D. Serai
Abdominal Radiology.2019; 44(9): 3058. CrossRef
Inhibition of mitochondrial fatty acid oxidation in drug-induced hepatic steatosis
Bernard Fromenty
Liver Research.2019; 3(3-4): 157. CrossRef
Standardising the interpretation of liver biopsies in non‐alcoholic fatty liver disease clinical trials
Rish K. Pai, David E. Kleiner, John Hart, Oyedele A. Adeyi, Andrew D. Clouston, Cynthia A. Behling, Dhanpat Jain, Sanjay Kakar, Mayur Brahmania, Lawrence Burgart, Kenneth P. Batts, Mark A. Valasek, Michael S. Torbenson, Maha Guindi, Hanlin L. Wang, Veeral
Alimentary Pharmacology & Therapeutics.2019; 50(10): 1100. CrossRef
NAFLD Histology: a Critical Review and Comparison of Scoring Systems
Rish K. Pai
Current Hepatology Reports.2019; 18(4): 473. CrossRef
Hepatic sonic hedgehog protein expression measured by computer assisted morphometry significantly correlates with features of non-alcoholic steatohepatitis
Michael Estep, Rohini Mehta, Gary Bratthauer, Lakshmi Alaparthi, Fanny Monge, Simon Ali, Dinan Abdelatif, Zahra Younoszai, Maria Stepanova, Zachary D. Goodman, Zobair M. Younossi
BMC Gastroenterology.2019;[Epub] CrossRef
Validation of intimate correlation between visceral fat and hepatic steatosis: Quantitative measurement techniques using CT for area of fat and MR for hepatic steatosis
Moon Hyung Choi, Joon-Il Choi, Michael Yong Park, Sung Eun Rha, Soon Nam Oh, Seung Eun Jung, Jae Young Byun, Stephan Kannengiesser, Yohan Son
Clinical Nutrition.2018; 37(1): 214. CrossRef
Ultrasound or MR elastography of liver: which one shall I use?
Meng Yin, Sudhakar K. Venkatesh
Abdominal Radiology.2018; 43(7): 1546. CrossRef
Feasibility and agreement of stiffness measurements using gradient-echo and spin-echo MR elastography sequences in unselected patients undergoing liver MRI
Guilherme Moura Cunha, Kevin J Glaser, Anke Bergman, Rodrigo P Luz, Eduardo H de Figueiredo, Flavia Paiva Proença Lobo Lopes
The British Journal of Radiology.2018; : 20180126. CrossRef
Second harmonic generation microscopy provides accurate automated staging of liver fibrosis in patients with non-alcoholic fatty liver disease
Pik Eu Chang, George Boon Bee Goh, Wei Qiang Leow, Liang Shen, Kiat Hon Lim, Chee Kiat Tan, Manlio Vinciguerra
PLOS ONE.2018; 13(6): e0199166. CrossRef

Proposal for a Standardized Pathology Report of Gastroenteropancreatic Neuroendocrine Tumors: Prognostic Significance of Pathological Parameters: Mee-Yon Cho, Jin Hee Sohn, So Young Jin, Hyunki Kim, Eun Sun Jung, Mi-Jung Kim, Kyoung-Mee Kim, Woo Ho Kim, Joon Mee Kim, Yun Kyung Kang, Joon Hyuk Choi, Dae Young Kang, Youn Wha Kim, Eun Hee Choi; Korean J Pathol. 2013;47(3):227-237. Published online June 25, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.3.227

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Abstract PDF

Background

There is confusion in the diagnosis and biological behaviors of gastroenteropancreatic neuroendocrine tumors (GEP-NETs), because of independently proposed nomenclatures and classifications. A standardized form of pathology report is required for the proper management of patients.

Methods

We discussed the proper pathological evaluation of GEP-NET at the consensus conference of the subcommittee meeting for the Gastrointestinal Pathology Study Group of the Korean Society of Pathologists. We then verified the prognostic significance of pathological parameters from our previous nationwide collection of pathological data from 28 hospitals in Korea to determine the essential data set for a pathology report.

Results

Histological classification, grading (mitosis and/or Ki-67 labeling index), T staging (extent, size), lymph node metastasis, and lymphovascular and perineural invasion were significant prognostic factors and essential for the pathology report of GEP-NET, while immunostaining such as synaptophysin and chromogranin may be optional. Furthermore, the staging system, either that of the 2010 American Joint Cancer Committee (AJCC) or the European Neuroendocrine Tumor Society (ENETS), should be specified, especially for pancreatic neuroendocrine neoplasms.

Conclusions

A standardized pathology report is crucial for the proper management and prediction of prognosis of patients with GEP-NET.

Citations

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Analysis of Prognostic Risk Factors of Endoscopic Submucosal Dissection (ESD) and Curative Resection of Gastrointestinal Neuroendocrine Neoplasms
Yuan Si, ChaoKang Huang, JingBin Yuan, XianHui Zhang, QingQiang He, ZhiJin Lin, Ling He, ZhongXin Liu, Yuvaraja Teekaraman
Contrast Media & Molecular Imaging.2022;[Epub] CrossRef
Standardization of the pathologic diagnosis of appendiceal mucinous neoplasms
Dong-Wook Kang, Baek-hui Kim, Joon Mee Kim, Jihun Kim, Hee Jin Chang, Mee Soo Chang, Jin-Hee Sohn, Mee-Yon Cho, So-Young Jin, Hee Kyung Chang, Hye Seung Han, Jung Yeon Kim, Hee Sung Kim, Do Youn Park, Ha Young Park, So Jeong Lee, Wonae Lee, Hye Seung Lee,
Journal of Pathology and Translational Medicine.2021; 55(4): 247. CrossRef
Preoperative diagnosis of well‐differentiated neuroendocrine tumor in common hepatic duct by brush cytology: A case report
Jiwoon Choi, Kyong Joo Lee, Sung Hoon Kim, Mee‐Yon Cho
Diagnostic Cytopathology.2019; 47(7): 720. CrossRef
Primary renal well-differentiated neuroendocrine tumors: report of six cases with an emphasis on the Ki-67 index and mitosis
Bohyun Kim, Han-Seong Kim, Kyung Chul Moon
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Primary low‐grade neuroendocrine carcinoma of the skin: An exceedingly rare entity
Tiffany Y. Chen, Annie O. Morrison, Joe Susa, Clay J. Cockerell
Journal of Cutaneous Pathology.2017; 44(11): 978. CrossRef
Prognostic Validity of the American Joint Committee on Cancer and the European Neuroendocrine Tumors Staging Classifications for Pancreatic Neuroendocrine Tumors
Jae Hee Cho, Ji Kon Ryu, Si Young Song, Jin-Hyeok Hwang, Dong Ki Lee, Sang Myung Woo, Young-Eun Joo, Seok Jeong, Seung-Ok Lee, Byung Kyu Park, Young Koog Cheon, Jimin Han, Tae Nyeun Kim, Jun Kyu Lee, Sung-Hoon Moon, Hyunjin Kim, Eun Taek Park, Jae Chul Hw
Pancreas.2016; 45(7): 941. CrossRef
Early diagnosis and treatment of gastrointestinal neuroendocrine tumors
Hong Shen, Zhuo Yu, Jing Zhao, Xiu-Zhen Li, Wen-Sheng Pan
Oncology Letters.2016; 12(5): 3385. CrossRef
Recent Updates on Neuroendocrine Tumors From the Gastrointestinal and Pancreatobiliary Tracts
Joo Young Kim, Seung-Mo Hong
Archives of Pathology & Laboratory Medicine.2016; 140(5): 437. CrossRef
Pancreatic neuroendocrine tumors: Correlation between the contrast-enhanced computed tomography features and the pathological tumor grade
Koji Takumi, Yoshihiko Fukukura, Michiyo Higashi, Junnichi Ideue, Tomokazu Umanodan, Hiroto Hakamada, Ichiro Kanetsuki, Takashi Yoshiura
European Journal of Radiology.2015; 84(8): 1436. CrossRef
Tumeurs neuroendocrines du tube digestif et du pancréas : ce que le pathologiste doit savoir et doit faire en 2014
Jean-Yves Scoazec, Anne Couvelard
Annales de Pathologie.2014; 34(1): 40. CrossRef
Spectrum of Gastroenteropancreatic NENs in Routine Histological Examinations of Bioptic and Surgical Specimen: A Study of 161 Cases Collected from 17 Departments of Pathology in the Czech Republic
Václav Mandys, Tomáš Jirásek
Gastroenterology Research and Practice.2014; 2014: 1. CrossRef
p27 Loss Is Associated with Poor Prognosis in Gastroenteropancreatic Neuroendocrine Tumors
Hee Sung Kim, Hye Seung Lee, Kyung Han Nam, Jiwoon Choi, Woo Ho Kim
Cancer Research and Treatment.2014; 46(4): 383. CrossRef

Update on the Proposal for Creating a Guideline for Cancer Registration of the Gastrointestinal Tumors (I-2): Eun Sun Jung, Yun Kyung Kang, Mee-Yon Cho, Joon Mee Kim, Won Ae Lee, Hee Eun Lee, Sunhoo Park, Jin Hee Sohn, So-Young Jin; Korean J Pathol. 2012;46(5):443-453. Published online October 25, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.5.443

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Abstract PDF

Background

Cancer registries play a fundamental role in cancer control and multicenter collaborative research. Recently, the need for reassessment of cancer registry criteria has arisen due to the newly released 2010 World Health Organization (WHO) classification. Accordingly, development of new coding guidelines for cancer is necessary to improve the quality of cancer registries, as well as to prevent conflicts that may arise when seeking medical insurance compensation.

Methods

With funding from the Management Center for Health Promotion, 35 members of the Gastrointestinal Pathology Study Group and the Cancer Registration Committee of the Korean Society of Pathologists (KSP) participated in a second workshop for gastrointestinal tumor registration in Korea.

Results

The topics of gastric epithelial tumor, colonic intramucosal carcinoma, neuroendocrine tumor (NET), gastrointestinal stromal tumor (GIST) and appendiceal mucinous tumor were discussed for new coding guidelines. A survey was then conducted among 208 members of the KSP for a consensus of the guidelines proposed in the workshop.

Conclusions

Although a few issues were set aside for further discussion, such as coding for non-gastric GIST and some types of NET, the members agreed upon most of the proposed guidelines. Therefore, we suggest using the newly revised International Classification of Diseases for Oncology, 3rd edition (ICD-O-3) coding guidelines for registering gastrointestinal tumors in Korea.

Citations

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Different miRNAs Related to FBXW7 Mutations or High Mitotic Indices Contribute to Rectal Neuroendocrine Tumors: A Pilot Study
Ho Suk Kang, Ha Young Park, Hyun Lim, Il Tae Son, Min-Jeong Kim, Nan Young Kim, Min Jeong Kim, Eun Sook Nam, Seong Jin Cho, Mi Jung Kwon
International Journal of Molecular Sciences.2023; 24(7): 6329. CrossRef
Clinicopathologic Impact of Peptide Hormonal Expression in Rectal Neuroendocrine Tumors
Jisup Kim, Dong-Hoon Yang, HaeSung Jung, HyungJun Cho, Hyeung-Jin Jang, Changhoon Yoo, In Ja Park, Baek-Yeol Ryoo, Jin-Sook Ryu, Seung-Mo Hong
Archives of Pathology & Laboratory Medicine.2023; 147(7): 797. CrossRef
Prognostic nomogram and novel risk-scoring system for small cell lung cancer with different patterns of metastases
Hongli Ruan, Huali Sun, Yu Guo, Yan Ding, Yanmei Liu, Shenpeng Ying, Peipei Lin
General Thoracic and Cardiovascular Surgery.2022; 70(12): 1022. CrossRef
Development of a nomogram model to predict survival outcomes in patients with primary hepatic neuroendocrine tumors based on SEER database
Ziteng Zhang, Xin Zhao, Zhiyan Li, Youchun Wu, Yao Liu, Zhiwei Li, Guobao Li
BMC Cancer.2021;[Epub] CrossRef
Standardization of the pathologic diagnosis of appendiceal mucinous neoplasms
Dong-Wook Kang, Baek-hui Kim, Joon Mee Kim, Jihun Kim, Hee Jin Chang, Mee Soo Chang, Jin-Hee Sohn, Mee-Yon Cho, So-Young Jin, Hee Kyung Chang, Hye Seung Han, Jung Yeon Kim, Hee Sung Kim, Do Youn Park, Ha Young Park, So Jeong Lee, Wonae Lee, Hye Seung Lee,
Journal of Pathology and Translational Medicine.2021; 55(4): 247. CrossRef
Analysis of the Incidence and Clinical Features of Colorectal Nonadenocarcinoma in Korea: A National Cancer Registry-Based Study
Soomin Nam, Dongwook Kim, Kyuwon Jung, Yoon Jung Choi, Jung Gu Kang
Annals of Coloproctology.2020; 36(6): 390. CrossRef
Novel Finding of Paired Box 5 (PAX5) Cytoplasmic Staining in Well-differentiated Rectal Neuroendocrine Tumors (Carcinoids) and Its Diagnostic and Potentially Prognostic Utility
Zhiyan Fu, Chunlai Zuo, Christine E. Sheehan, Deepa T. Patil, Jingmei Lin, Zhaohai Yang, Hwajeong Lee
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Lymphovascular invasion as a prognostic value in small rectal neuroendocrine tumor treated by local excision: A systematic review and meta-analysis
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Yuda Handaya, Sutamto Wibowo, Iwan Kristian
Open Journal of Gastroenterology.2016; 06(04): 97. CrossRef
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Diagnostic Coding for Intramucosal Carcinoma and Neuroendocrine Tumor in the Colorectum: Proposal for Avoiding Confusing Coding in Korea
Dong Soo Han, Jin Hee Sohn, Jeong-Sik Byeon, Hwang Choi, Joon Mee Kim
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Eun Young Kim, Il Ju Choi, Kwang An Kwon, Ji Kon Ryu, Seok Ho Dong, Ki Baik Hahm
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Detection Limit of Monoclonal B-Cells Using Multiplex PCR and Laser-Induced Fluorescence Capillary Electrophoresis.: Sung Hak Lee, Yeonsook Moon, Byunghoo Song, Hyung Nam Lee, Ahwon Lee, Eun Sun Jung, Yeong Jin Choi, Kyo Young Lee, Chang Suk Kang, Gyeongsin Park; Korean J Pathol. 2011;45(6):582-588.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.6.582

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Abstract PDF

BACKGROUND
The identification of monoclonality has been widely used for making diagnoses of lymphoproliferative lesions. Awareness of the sensitivity and detection limit of the technique used would be important for the data to be convincing.
METHODS
We investigated the minimum requirement of cells and sensitivity of gel electrophoresis (GE) and laser-induced fluorescence capillary electrophoresis (LFCE) for identifying IgH gene rearrangement using BIOMED-2 protocols. DNA extracted from Raji cells were diluted serially with peripheral blood mononuclear cells (PBMNCs) DNA. DNA from mixtures of diffuse large B-cell lymphoma (DLBCL) and reactive lymph nodes were also serially diluted.
RESULTS
For Raji cells, the detection limit was 62 and 16 cell-equivalents for GE and LFCE, respectively. In the condition with PBMNCs mixture, 2.5% and 1.25% of clonal cells was the minimum requirement for GE and LFCE, respectively. In 23% of DLBCL cells in tissue section, the detection limit was 120 and 12 cell-equivalents for GE and LFCE, respectively. In 3.2% of DLBCL cells, that was 1,200 and 120 cell-equivalents for GE and LFCE, respectively.
CONCLUSIONS
These results show that LFCE method is more sensitive than GE and the sensitivity of clonality detection can be influenced by the amount of admixed normal lymphoid cells.

Citations

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Molecular pathology diagnosis of diffuse large B cell lymphoma using BIOMED-2 clonal gene rearrangements
Saeid Ghorbian
Annals of Diagnostic Pathology.2017; 29: 28. CrossRef

Case Report

Apocrine Carcinoma of the Axilla with Predominant Signet Ring Cell Features A Case Report.: Jeana Kim, Tae Eun Kim, Ah Won Lee, Yeong Jin Choi, Kyo Young Lee, Eun Sun Jung; Korean J Pathol. 2011;45(3):326-328.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.3.326

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Abstract PDF: Apocrine carcinoma arising from the apocrine sweat glands is a rare cutaneous malignant tumor which occurs predominantly in the axilla of elderly individuals. The typical histologic features of apocrine carcinoma is within a well developed glandular lumina with abundant eosinophilic cytoplasm and evidence of decapitation secretion. In rare instances, predominant signet ring cell features in apocrine carcinoma has been reported. We experienced a case that occured in the right axilla of a 59-year-old. Histopathologic examination showed a solid tumor that extended from the upper dermis into the subcutis, with a delicate infiltrate of epithelial cells. The cells had granular amphophilic cytoplasm, predominantly showed distinct signet ring cell morphology, and were strongly positive for epithelial mucin. Both lysozyme and gross cystic disease fluid protein-15 were identified in the tumor cells. We diagnosed this to be a case of primary signet ring cell apocrine carcinoma of the axilla after several immunohistochemical and clinical evaluations.

Original Articles

The Usefulness of p16INK4a Immunocytochemical Staining in ASC-H Patients.: Kwang Il Yim, Yeo Ju Kang, Tae Eun Kim, Gyeongsin Park, Eun Sun Jung, Yeong Jin Choi, Kyo Young Lee, Chang Seok Kang, Ahwon Lee; Korean J Pathol. 2011;45(3):290-295.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.3.290

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Abstract PDF

BACKGROUND
The grey zone of cervical cytology, and in particular atypical squamous cells, cannot exclude HSIL (ASC-H) causes diagnostic difficulties and increases medical expenses. We analyzed p16INK4a expression in ASC-H liquid-based cytology specimens (LBCS) to develop more effective methods for the management of ASC-H patients.
METHODS
We carried out p16INK4a immunostaining with 57 LBCS of ASC-H diagnostic categories, all of which were histologically cofirmed and 43 cases of which were compared with the results of a human papillomavirus (HPV) chip test.
RESULTS
p16INK4a immunostaining with ASC-H LBCS was positive in 20% (3/15) of cervicitis, 25.0% (3/12) of tissue-low-grade squamous intraepithelial lesion, 75.0% (18/24) of tissue-high grade squamous intraepithelial lesion (HSIL), and 100% (6/6) of invasive cancer cases. The positivity of p16INK4a in LBCS was correlated with higher grade of histologic diagnosis (r=0.578, p=0.000). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of p16INK4a immunostaining for the prediction of tissue-HSIL+ were 80.0%, 77.8%, 80.0%, and 77.8%, respectively. The sensitivity, specificity, PPV, and NPV of p16INK4a immunostaining plus HPV chip test for predicting tissue-HSIL+ were 71.2%, 86.4%, 84.2%, and 79.2%.
CONCLUSIONS
p16INK4a immunostaining as well as HPV chip testing with remaining LBCS with ASC-H are useful objective markers for the prediction of tissue-HSIL+.

Citations

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Usefulness of p16INK4a Immunocytochemical staining for the Differentiation between Atrophy and ASCUS in Diagnosis of Uterine Cervical Cancer
Hye Ryoung Shin, Taekil Eom, Wan-Su Choi
Biomedical Science Letters.2023; 29(3): 144. CrossRef

Alteration of Bile Acid Transporter Expression in Patients with Early Cholestasis Following Living Donor Liver Transplantation.: Eun Sun Jung, Byung Kee Kim, So Youn Kim, Youn Soo Lee, Si Hyun Bae, Seung Kew Yoon, Jong Young Choi, Young Min Park, Dong Goo Kim; Korean J Pathol. 2009;43(1):48-55.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.1.48

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Abstract PDF: BACKGROUND
Intrahepatic cholestasis can occur early after living donor liver transplantation (LDLT). We investigated the changes in the expressions of the bile acid transporters and the liver histology in the patients who suffered with early cholestasis (EC) following LDLT.
METHODS
The histological differences between 15 graft livers with EC after LDLT and 5 graft livers with biliary stricture following LDLT were evaluated. The hepatic mRNA levels of the bile canaliculi transporters (BSEP, MRP2, MRP3, MDR1, MDR3, NTCP) in 40 (20 graft livers, 20 matched donor livers) liver biopsy tissues were analyzed by performing real-time reverse-transcription polymerase chain reaction (RT-PCR).
RESULTS
Microscopic examination revealed hepatocellular and/or bile canalicular cholestasis around acinar zone 3 in the livers of the patients with EC. In the livers with biliary stricture, the cholestasis was dominantly observed in the hepatocytic cytoplasm and in the bile ductules around the portal area rather than around acinar zone 3. The BSEP and MRP2 mRNA levels in the EC livers were significantly reduced by 44% and 23%, respectively (p=0.000), compared to the matched donor livers. The levels of MDR3 and NTCP mRNA in the EC livers increased by 738% (p=0.000) and 281% (p<0.01), respectively. The change of the expressions of the bile acid transporters in the patients with biliary stricture was less significant than that in the EC group.
CONCLUSIONS
These results suggest that the altered expressions of the bile acid transporters may play a role in the pathogenesis of EC following LDLT.

Comparison of Clinical Efficacy between an HPV DNA Chip and a Hybrid-Capture II Assay in a Patient with Abnormal Colposcopic Findings.: Tae Jung Kim, Chan Kwon Jung, Ahwon Lee, Eun Sun Jung, Young Jin Choi, Kyo Young Lee, Jong Sup Park; Korean J Cytopathol. 2008;19(2):119-125.; DOI: https://doi.org/10.3338/kjc.2008.19.2.119

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Abstract PDF

This study was performed to compare the efficacy between a DNA chip method and a Hybrid-Capture II assay (HC-II) for detecting human papillomavirus in patients with intraepithelial lesions of the uterine cervix. From May, 2005, to June, 2006, 192 patients with abnormal colposcopic findings received cervical cytology, HC-II and HPV DNA chip tests, and colposcopic biopsy or conization. We compared the results of HC-II and HPV DNA chip in conjunction with liquid based cervical cytology (LBCC) and confirmed the results of biopsy or conization. The sensitivity of the HPV DNA chip test was higher than HC-II or LBCC. The HPV DNA chip in conjunction with LBCC showed higher sensitivity than any single method and higher sensitivity than HC-II with LBCC. We confirmed that the HPV DNA chip test was more sensitive for detecting HPV in cervical lesions than HC-II, and that it would provide more useful clinical information about HPV type and its multiple infections.

Citations

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Comparison of Analytical and Clinical Performance of HPV 9G DNA Chip, PANArray HPV Genotyping Chip, and Hybrid-Capture II Assay in Cervicovaginal Swabs
Ho Young Jung, Hye Seung Han, Hyo Bin Kim, Seo Young Oh, Sun-Joo Lee, Wook Youn Kim
Journal of Pathology and Translational Medicine.2016; 50(2): 138. CrossRef

Case Reports

Malignant Melanoma of the Anus: Report of a case.: Eun Sun Jung, Byung Kee Kim, Sun Moo Kim, Sang In Shim; Korean J Pathol. 1996;30(3):276-278.

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Abstract PDF: This report describes a primary malignant melanoma which developed in the anus, as documented by light microscopy and immunohistochemistry. A 53-year-old woman had a 4 month history of a protruding mass in the anal canal. The mass was located in the squamo-columnar junction of the anal canal, measuring 5.0x4.5 cm. Its cut surface was dark brown and poorly circumscribed. The histologic appearance was characterized by epithelioid or spindle cells with prominant nucleoli and frequent atypical mitosis. Melanin pigments were strongly seen in Fontana-Masson stain. Immunoreactivity revealed that the cytoplasm of tumor cells was strongly positive with antibody directed against S-100 protein, vimentin and it was focally positive with neuron specific enolase.

Sarcomatoid Carcinoma with Heterologous Osteosarcomatous Component of the Prostate: A case report.: Eun Sun Jung, Young Jin Choi, Seok Jin Kang, Byung Gee Kim, Sun Moo Kim, Sang In Shim; Korean J Pathol. 1996;30(12):1144-1149.

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Abstract PDF: Sarcomatoid carcinoma of prostate has been rarely reported and occasionally difficult to distinguish from a true sarcoma or carcinosarcoma. A case of sarcomatoid carcinoma of the prostate, which has been occured in 61-year-old male patient is presented. The tumor consists of carcinomatous areas with epithelioid cells, sarcomatoid areas with spindle cells and foci of heterologous osteosarcoma component. The phenotypic nature of the tumor was confirmed immunohistochemically by positive reaction for cytokeratin, epithelial membrane antigen, vimentin and prostate specific acid phosphatase in both sarcomatous and carcinomatous components.

Original Article

Expression of Matrix Metalloproteinase-1,2,3 and Type IV Collagen in Gastric Adenocarcinoma: Influence on Lymph Node Metastasis and Prognosis.: Eun Sun Jung, Byung Gee Kim, Jo Hyun Park, Sang In Shim; Korean J Pathol. 1999;33(4):251-258.

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Abstract PDF: Matrix metalloproteinases are believed to play an important role in tumor invasion and metastasis. But little is known about the role of them in the gastric adenocarcinoma. We investigated the expression of matrix metalloproteinase-1,2,3 in eighty paraffin blocks of the primary gastric adenocarcinoma tissues with immunohistochemistry and analysed their correlation with lymph node metastasis and survival. MMP-1,2,3 were expressed most intensely in the fibroblasts around the tumor stroma. In our study the increased immunoreactivity of MMP-2 only showed statistically significant correlation with lymph node metastasis (P=0.0517, Odd's ratio=2.274). But MMP-1,2,3 all were correlated with survival. Type IV collagen was observed in the vascular basement membranes and tumor basement membranes and showed statistically significant correlation with lymph node metastasis (P=0.0002, Odd's ratio=0.194) and prognosis (P=0.0001). The immunoreactivity of MMP-2 and type IV collagen was inversely correlated (Kendall's Tau-b correlation = 0.37482, P=0.0001). Our results suggest that in human gastric adenocarcinoma the increased immunoreactivity of MMP-2 and the decreased immunoreactivity of type IV collagen has an important role in lymph node metastasis and prognosis. MMP-1,3 are not correlated with lymph node metastasis but correlated with survival. The mechanism responsible for the production of MMP by the host fibroblasts remains obscure and requires further investigation.

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