Journal of Pathology and Translational Medicine

Original Articles

Expression of female sex hormone receptors and its relation to clinicopathological characteristics and prognosis of lung adenocarcinoma: Jin Hwan Lee, Han Kyeom Kim, Bong Kyung Shin; J Pathol Transl Med. 2020;54(1):103-111. Published online November 13, 2019; DOI: https://doi.org/10.4132/jptm.2019.10.12

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Background
Adenocarcinoma (ADC) of the lung exhibits different clinicopathological characteristics in men and women. Recent studies have suggested that these differences originate from the expression of female sex hormone receptors in tumor cells. The aim of the present study was to evaluate the immunohistochemical expression of female sex hormone receptors in lung ADC and determine the expression patterns in patients with different clinicopathological characteristics.
Methods
A total of 84 patients with lung ADC who underwent surgical resection and/or core biopsy were recruited for the present study. Immunohistochemical staining was performed for estrogen receptor α (ERα), estrogen receptor β (ERβ), progesterone receptor (PR), epidermal growth factor receptor (EGFR), EGFR E746- A750 del, and EGFR L858R using tissue microarray.
Results
A total of 39 (46.4%) ERα-positive, 71 (84.5%) ERβ-positive, and 46 (54.8%) PR-positive lung ADCs were identified. In addition, there were 81 (96.4%) EGFR-positive, 14 (16.7%) EGFR E746-A750 del–positive, and 34 (40.5%) EGFR L858R–positive cases. The expression of female sex hormone receptors was not significantly different in clinicopathologically different subsets of lung ADC.
Conclusions
Expression of female sex hormone receptors is not associated with the prognosis and clinicopathological characteristics of patients with lung ADC.

Citations

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Molecular characteristics of non-small cell lung cancer tissue based on quantitative indicators of progesterone receptors expression
I. P. Romanov, T. A. Bogush, A. M. Scherbakov, A. A. Alimov, E. A. Bogush, A. B. Ravcheeva, A. Lee, V. S. Kosorukov
Antibiot Khimioter = Antibiotics and Chemotherapy.2024; 69(1-2): 29. CrossRef
Genes Co-Expressed with ESR2 Influence Clinical Outcomes in Cancer Patients: TCGA Data Analysis
Julia Maria Lipowicz, Agnieszka Malińska, Michał Nowicki, Agnieszka Anna Rawłuszko-Wieczorek
International Journal of Molecular Sciences.2024; 25(16): 8707. CrossRef
Complex Differential Diagnosis between Primary Breast Cancer and Breast Metastasis from EGFR-Mutated Lung Adenocarcinoma: Case Report and Literature Review
Carmine Valenza, Francesca Maria Porta, Alessandra Rappa, Elena Guerini-Rocco, Giuseppe Viale, Massimo Barberis, Filippo de Marinis, Giuseppe Curigliano, Chiara Catania
Current Oncology.2021; 28(5): 3384. CrossRef
Development of a 15‐Gene Signature Model as a Prognostic Tool in Sex Hormone‐Dependent Cancers
Zhi Xia, Jian Xiao, Aibin Liu, Qiong Chen, Arumugam R. Jayakumar
BioMed Research International.2021;[Epub] CrossRef
Gender-specific aspects of epidemiology, molecular genetics and outcome: lung cancer
Nuria Mederos, Alex Friedlaender, Solange Peters, Alfredo Addeo
ESMO Open.2020; 5(Suppl 4): e000796. CrossRef

Current Cytology Practices in Korea: A Nationwide Survey by the Korean Society for Cytopathology: Eun Ji Oh, Chan Kwon Jung, Dong-Hoon Kim, Han Kyeom Kim, Wan Seop Kim, So-Young Jin, Hye Kyoung Yoon; J Pathol Transl Med. 2017;51(6):579-587. Published online September 27, 2017; DOI: https://doi.org/10.4132/jptm.2017.08.11

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Abstract PDF

Background
Limited data are available on the current status of cytology practices in Korea. This nationwide study presents Korean cytology statistics from 2015.
Methods
A nationwide survey was conducted in 2016 as a part of the mandatory quality-control program by the Korean Society for Cytopathology. The questionnaire was sent to 208 medical institutions performing cytopathologic examinations in Korea. Individual institutions were asked to submit their annual cytology statistical reports and gynecologic cytology-histology correlation data for 2015.
Results
Responses were obtained from 206 medical institutions including 83 university hospitals, 87 general hospitals, and 36 commercial laboratories. A total of 8,284,952 cytologic examinations were performed in 2015, primarily in commercial laboratories (74.9%). The most common cytology specimens were gynecologic samples (81.3%). Conventional smears and liquid-based cytology were performed in 6,190,526 (74.7%) and 2,094,426 (25.3%) cases, respectively. The overall diagnostic concordance rate between cytologic and histologic diagnoses of uterine cervical samples was 70.5%. Discordant cases were classified into three categories: category A (minimal clinical impact, 17.4%), category B (moderate clinical impact, 10.2%), and category C (major clinical impact, 1.9%). The ratio of atypical squamous cells of undetermined significance to squamous intraepithelial lesion was 1.6 in university hospitals, 2.9 in general hospitals, and 4.9 in commercial laboratories.
Conclusions
This survey reveals the current status and trend of cytology practices in Korea. The results of this study can serve as basic data for the establishment of nationwide cytopathology policies and quality improvement guidelines in Korean medical institutions.

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Endocrinology and Metabolism.2022; 37(5): 816. CrossRef
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Jung-A Sung, Ilias P. Nikas, Haeryoung Kim, Han Suk Ryu, Cheol Lee
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Current status of cytopathology practice in Korea: impact of the coronavirus pandemic on cytopathology practice
Soon Auck Hong, Haeyoen Jung, Sung Sun Kim, Min-Sun Jin, Jung-Soo Pyo, Ji Yun Jeong, Younghee Choi, Gyungyub Gong, Yosep Chong
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Systematic screening for cervical cancer in Dakar region: prevalence and correlation with biological and socio-demographic parameters
Dominique Diouf, Gora Diop, Cheikh Ahmadou Tidian Diarra, Aminata Issa Ngom, Khadija Niane, Moussa Ndiaye, Sidy Ka, Oumar Faye, Ahmadou Dem
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Continuous quality improvement program and its results of Korean Society for Cytopathology
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Comparison Study of the Adequacy and Pain Scale of Ultrasound-Guided Fine-Needle Aspiration of Solid Thyroid Nodules with a 21- or 23-Gauge Needle for Liquid-Based Cytology: a Single-Center Study
Soo Jin Jung, Dong Wook Kim, Hye Jin Baek
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Thyroid Fine-Needle Aspiration Cytology Practice in Korea
Yoon Jin Cha, Ju Yeon Pyo, SoonWon Hong, Jae Yeon Seok, Kyung-Ju Kim, Jee-Young Han, Jeong Mo Bae, Hyeong Ju Kwon, Yeejeong Kim, Kyueng-Whan Min, Soonae Oak, Sunhee Chang
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Case Studies

A Rare Case of Recurrent Metastatic Solid Pseudopapillary Neoplasm of the Pancreas: Hye Seung Lee, Han Kyeom Kim, Bong Kyung Shin, Jin Hyuk Choi, Yoo Jin Choi, Ha Yeon Kim; J Pathol Transl Med. 2017;51(1):87-91. Published online August 6, 2016; DOI: https://doi.org/10.4132/jptm.2016.06.16

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Abstract PDF

A 61-year-old woman visited our hospital for bilateral multiple lung nodules and a mass in her thorax. She had a long history of multiple metastatic recurrences of solid pseudopapillary neoplasm (SPN); 24 years previously, the patient had undergone pylorus-preserving pancreaticoduodenectomy for a 9.9 × 8.6 cm mass in the pancreatic head. The tumor was diagnosed as an SPN. Nine years later, metastatic nodules were found on computed tomography in the patient’s liver and peritoneum and were excised. She subsequently underwent an additional eight metastatectomy procedures in diverse organs. For the presented event, the lung nodules were removed. The prevalence of malignant SPN in the general population is 5%–15%. However, multiple metastatic recurrence of malignant SPN is rare; the lung is a particularly rare site of metastasis, found in only three cases in the literature. Here, we describe this exceptional case and provide a literature review.

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Sclerosing Perivascular Epithelioid Cell Tumor of the Lung: A Case Report with Cytologic Findings: Ha Yeon Kim, Jin Hyuk Choi, Hye Seung Lee, Yoo Jin Choi, Aeree Kim, Han Kyeom Kim; J Pathol Transl Med. 2016;50(3):238-242. Published online April 11, 2016; DOI: https://doi.org/10.4132/jptm.2016.02.19

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Abstract PDF

Benign perivascular epithelioid cell tumor (PEComa) of the lung is a rare benign neoplasm, a sclerosing variant of which is even rarer. We present a case of 51-year-old man who was diagnosed with benign sclerosing PEComa by percutaneous fine needle aspiration cytology and biopsy. The aspirate revealed a few cell clusters composed of bland-looking polygonal or spindle cells with fine granular or clear cytoplasm. Occasional fine vessel-like structures with surrounding hyalinized materials were seen. The patient later underwent wedge resection of the lung. The histopathological study of the resected specimen revealed sheets of polygonal cells with clear vacuolated cytoplasm, variably sized thin blood vessels, and densely hyalinized stroma. In immunohistochemical studies, reactivity of tumor cells for human melanoma black 45 and Melan-A further supported the diagnosis of benign sclerosing PEComa. To the best of our knowledge, this is the first case of benign sclerosing PEComa described in lung.

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Original Articles

Analysis of Mutations in Epidermal Growth Factor Receptor Gene in Korean Patients with Non-small Cell Lung Cancer: Summary of a Nationwide Survey: Sang Hwa Lee, Wan Seop Kim, Yoo Duk Choi, Jeong Wook Seo, Joung Ho Han, Mi Jin Kim, Lucia Kim, Geon Kook Lee, Chang Hun Lee, Mee Hye Oh, Gou Young Kim, Sun Hee Sung, Kyo Young Lee, Sun Hee Chang, Mee Sook Rho, Han Kyeom Kim, Soon Hee Jung, Se Jin Jang, The Cardiopulmonary Pathology Study Group of Korean Society of Pathologists; J Pathol Transl Med. 2015;49(6):481-488. Published online October 13, 2015; DOI: https://doi.org/10.4132/jptm.2015.09.14

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Abstract PDF

Background
Analysis of mutations in the epidermal growth factor receptor gene (EGFR) is important for predicting response to EGFR tyrosine kinase inhibitors. The overall rate of EGFR mutations in Korean patients is variable. To obtain comprehensive data on the status of EGFR mutations in Korean patients with lung cancer, the Cardiopulmonary Pathology Study Group of the Korean Society of Pathologists initiated a nationwide survey. Methods: We obtained 1,753 reports on EGFR mutations in patients with lung cancer from 15 hospitals between January and December 2009. We compared EGFR mutations with patient age, sex, history of smoking, histologic diagnosis, specimen type, procurement site, tumor cell dissection, and laboratory status. Results: The overall EGFR mutation rate was 34.3% in patients with non-small cell lung cancer (NSCLC) and 43.3% in patients with adenocarcinoma. EGFR mutation rate was significantly higher in women, never smokers, patients with adenocarcinoma, and patients who had undergone excisional biopsy. EGFR mutation rates did not differ with respect to patient age or procurement site among patients with NSCLC. Conclusions: EGFR mutation rates and statuses were similar to those in published data from other East Asian countries.

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Tumor Sprouting in Papillary Thyroid Carcinoma Is Correlated with Lymph Node Metastasis and Recurrence: Eunjung Lee, Wonkyung Jung, Jeong-Soo Woo, Jae Bok Lee, Bong Kyung Shin, Han Kyeom Kim, Aeree Kim, Baek-hui Kim; Korean J Pathol. 2014;48(2):117-125. Published online April 28, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.2.117

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Abstract PDF

Background

Identification of poor prognostic factors in papillary thyroid carcinoma (PTC) patients is important for the patients' care and follow-up. We can sometimes see small tumor clusters without desmoplasia and no evidence of lymphatic emboli around the main tumor mass of PTC. We termed this form of tumor clustering, 'tumor sprouting,' and determined whether these tumors correlate with lymphovascular invasion, lymph node metastasis, and recurrence.

Methods

We analyzed a total of 204 cases of papillary thyroid macrocarcinoma. Number, size and distance from the main tumor of the tumor sprouting were observed and analyzed with clinicopathologic characteristics.

Results

Tumor sprouting was observed in 101 patients. Presence of tumor sprouting was significantly associated with positive resection margin (p=.002), lymphovascular invasion (p=.001), lymph node metastasis (p<.001), and recurrence (p=.004). Univariate analysis of recurrence-free survival revealed that tumor multiplicity (p=.037), positive resection margin (p=.007), lymphovascular invasion (p=.004), lymph node metastasis (p<.001), and tumor sprouting (p=.004) were poor prognostic factors. In multivariate analysis, positive resection margin was an independent poor prognostic factor of recurrence.

Conclusions

In conclusion, tumor sprouting is significantly correlated with lymph node metastasis and recurrence. Evaluation of tumor sprouting in PTC patients could be helpful in predicting tumor recurrence or lymph node metastasis.

Citations

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The Initial Risk Stratification System for Differentiated Thyroid Cancer: Key Updates in the 2024 Korean Thyroid Association Guideline
Shinje Moon, Young Shin Song, Kyong Yeun Jung, Eun Kyung Lee, Jeongmin Lee, Dong-Jun Lim, Chan Kwon Jung, Young Joo Park
Endocrinology and Metabolism.2025; 40(3): 357. CrossRef
Korean Thyroid Association Guidelines on the Management of Differentiated Thyroid Cancers; Part I. Initial Management of Differentiated Thyroid Cancers - Chapter 5. Evaluation of Recurrence Risk Postoperatively and Initial Risk Stratification in Different
Eun Kyung Lee, Young Shin Song, Ho-Cheol Kang, Sun Wook Kim, Dong Gyu Na, Shin Je Moon, Dong-Jun Lim, Kyong Yeun Jung, Yun Jae Chung, Chan Kwon Jung, Young Joo Park
International Journal of Thyroidology.2024; 17(1): 68. CrossRef
Significance of Lymphovascular Invasion as a Prognostic Factor in Patients with Papillary Thyroid Cancer: a Systematic Review and Meta-Analysis
Ho-Ryun Won, Bon Seok Koo
International Journal of Thyroidology.2023; 16(2): 157. CrossRef
Peripheral Versus Intraparenchymal Papillary Thyroid Microcarcinoma: Different Morphologies and PD-L1 Expression
Bozidar Kovacevic, Dragana Vucevic, Snezana Cerovic, Catarina Eloy
Head and Neck Pathology.2022; 16(1): 200. CrossRef
Lymphovascular invasion and risk of recurrence in papillary thyroid carcinoma
Katy Wagner, Earl Abraham, Bryan Tran, David Roshan, James Wykes, Peter Campbell, Ardalan Ebrahimi
ANZ Journal of Surgery.2020; 90(9): 1727. CrossRef
The Predictors of Multicentricity in Well-Differentiated Thyroid Cancer
Mohamed Hegazi, Waleed El Nahas, Mohamed Elmetwally, Amr Hassan, Waleed Gado , Islam Abdou, Ahmed Senbel, Mohamed Samir Abou-Sheishaa
Journal of Analytical Oncology.2018; 7(4): 65. CrossRef
Prognostic impact of vascular invasion in differentiated thyroid carcinoma: a systematic review and meta-analysis
Huy Gia Vuong, Tetsuo Kondo, Uyen N P Duong, Thong Quang Pham, Naoki Oishi, Kunio Mochizuki, Tadao Nakazawa, Lewis Hassell, Ryohei Katoh
European Journal of Endocrinology.2017; 177(2): 207. CrossRef
Detection of Tumor Multifocality Is Important for Prediction of Tumor Recurrence in Papillary Thyroid Microcarcinoma: A Retrospective Study and Meta-Analysis
Jung-Soo Pyo, Jin Hee Sohn, Guhyun Kang
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SIRT1 Expression Is Associated with Good Prognosis in Colorectal Cancer: Wonkyung Jung, Kwang Dae Hong, Woon Yong Jung, Eunjung Lee, Bong Kyung Shin, Han Kyeom Kim, Aeree Kim, Baek-hui Kim; Korean J Pathol. 2013;47(4):332-339. Published online August 26, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.4.332

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Abstract PDF

Background

Silent mating type information regulation 2 homolog 1 (SIRT1), an NAD+-dependent deacetylase, might act as a tumor promoter by inhibiting p53, but may also as a tumor suppressor by inhibiting several oncogenes such as β-catenin and survivin. Deleted in breast cancer 1 (DBC1) is known as a negative regulator of SIRT1.

Methods

Immunohistochemical expressions of SIRT1, DBC1, β-catenin, surviving, and p53 were evaluated using 2 mm tumor cores from 349 colorectal cancer patients for tissue microarray.

Results

Overexpression of SIRT1, DBC1, survivin, and p53 was seen in 235 (67%), 183 (52%), 193 (55%), and 190 (54%) patients, respectively. Altered expression of β-catenin was identified in 246 (70%) patients. On univariate analysis, overexpression of SIRT1 (p=0.029) and altered expression of β-catenin (p=0.008) were significantly associated with longer overall survival. Expression of SIRT1 was significantly related to DBC1 (p=0.001), β-catenin (p=0.001), and survivin (p=0.002), but not with p53. On multivariate analysis, age, tumor stage, differentiation, and expression of SIRT1 were independent prognostic factors significantly associated with overall survival.

Conclusions

SIRT1 overexpression is a good prognostic factor for colorectal cancer, and SIRT1 may interact with β-catenin and survivin rather than p53.

Citations

Citations to this article as recorded by

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Prognostic Significance of Heat Shock Protein 70 Expression in Early Gastric Carcinoma: Youngran Kang, Woon Yong Jung, Hyunjoo Lee, Wonkyung Jung, Eunjung Lee, Bong Kyung Shin, Aeree Kim, Han Kyeom Kim, Baek-hui Kim; Korean J Pathol. 2013;47(3):219-226. Published online June 25, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.3.219

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Abstract PDF

Background

Overexpression of heat shock protein 70 (HSP70) has been observed in many types of cancer including gastric adenocarcinomas, although the exact role of HSP70 in carcinogenesis remains unclear.

Methods

The study analyzed a total of 458 radical gastrectomy specimens which were immunohistochemically stained with HSP70, p53, and Ki-67 antibodies.

Results

The study determined that the expression of HSP70 was significantly increased in early gastric cancer (EGC) compared to advanced gastric cancer (p<0.001). The HSP70 expression was correlated with well-differentiated tumor type, intestinal type of Lauren classification and the lower pT and pN stage. Negative expression of Ki-67 and p53 expression was associated with poor prognosis. The study did not find any correlation between HSP70 and p53 expression. The study determined that HSP70 expression in the EGC subgroup was associated with a poor prognosis (p=0.009), as well as negative Ki-67 expression (p=0.006), but was not associated with p53. Based on multivariate analysis, HSP70 expression (p=0.024), negative expression of Ki-67, invasion depth and lymph node metastasis were determined to be independent prognostic markers.

Conclusions

HSP70 is expressed in the early stages of gastric adenocarcinoma. In EGC, HSP70 is a poor independent prognostic marker and is correlated with a low proliferation index.

Citations

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The Prognostic Importance of Ki-67 in Gastrointestinal Carcinomas: A Meta-analysis and Multi-omics Approach
Mahdieh Razmi, Fatemeh Tajik, Farideh Hashemi, Ayna Yazdanpanah, Fatemeh Hashemi-Niasari, Adeleh Divsalar
Journal of Gastrointestinal Cancer.2024; 55(2): 599. CrossRef
Clinicopathological significance of HSP70 expression in gastric cancer: a systematic review and meta-analysis
Xiaolu Wang, Li Xie, Lijing Zhu
BMC Gastroenterology.2021;[Epub] CrossRef
Beta-sheet-specific interactions with heat shock proteins define a mechanism of delayed tumor cell death in response to HAMLET
Aftab Nadeem, James C.S. Ho, Tuan Hiep Tran, Sanchari Paul, Victoria Granqvist, Nadege Despretz, Catharina Svanborg
Journal of Molecular Biology.2019; 431(14): 2612. CrossRef
Evolving paradigms on the interplay of mitochondrial Hsp70 chaperone system in cell survival and senescence
Shubhi Srivastava, Vinaya Vishwanathan, Abhijit Birje, Devanjan Sinha, Patrick D’Silva
Critical Reviews in Biochemistry and Molecular Biology.2019; 54(6): 517. CrossRef
Clinicopathologic significance and prognostic value of Ki-67 expression in patients with gastric cancer: a meta-analysis
Guanying Luo, Yunzhao Hu, Zhiqiao Zhang, Peng Wang, Zhaowen Luo, Jinxin Lin, Canchang Cheng, You Yang
Oncotarget.2017; 8(30): 50273. CrossRef
Extracellular HSP70-peptide complexes promote the proliferation of hepatocellular carcinoma cells via TLR2/4/JNK1/2MAPK pathway
Yi Zhe, Yan Li, Dan Liu, Dong-Ming Su, Jin-Gang Liu, Hang-Yu Li
Tumor Biology.2016; 37(10): 13951. CrossRef
The cytomegalovirus protein UL138 induces apoptosis of gastric cancer cells by binding to heat shock protein 70
Wenjing Chen, Kezhi Lin, Liang Zhang, Gangqiang Guo, Xiangwei Sun, Jing Chen, Lulu Ye, Sisi Ye, Chenchen Mao, Jianfeng Xu, Lifang Zhang, Lubin Jiang, Xian Shen, Xiangyang Xue
Oncotarget.2016; 7(5): 5630. CrossRef
Targeting the hsp70 gene delays mammary tumor initiation and inhibits tumor cell metastasis
J Gong, D Weng, T Eguchi, A Murshid, M Y Sherman, B Song, S K Calderwood
Oncogene.2015; 34(43): 5460. CrossRef

Vascular Endothelial Growth Factor Bioactivity and Its Receptors in Patients with Acute Respiratory Distress Syndrome.: Simona Gurzu, Ioan Jung, Leonard Azamfirei, Bong Young Shin, Raluca Solomon, Daria Demian, Judith Kovacs, Han Kyeom Kim; Korean J Pathol. 2011;45(2):139-145.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.2.139

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Abstract PDF

BACKGROUND
Pathogenesis of acute respiratory distress syndrome (ARDS) is a controversial issue. Few studies have analyzed the possible role of vascular endothelial growth factor (VEGF) and its receptors in this lesion.
METHODS
We compared the immunohistochemical expression of VEGF, its receptors (VEGFR1, VEGFR2) and CD68, in normal lungs and lungs with ARDS. Fifty necropsy cases and 12 lung biopsies with ARDS were analyzed. In total, eight cases were in the early stage and 54 cases were in late stage of ARDS. In addition, the serum level of VEGF165 was also determined.
RESULTS
In normal lungs, all antibodies marked the endothelial cells (EC) and pneumocytes (PC), except for CD68, which was expressed in the alveolar macrophages. In early ARDS, the intensity of VEGF165 and VEGFR2 decreased in both EC and PC. VEGF121 was absent in PC but its expression increased in bronchial epithelium. VEGFR1 was expressed in the integral PC. In late ARDS, VEGF165 down-regulation was more significant in PC and EC but its intensity increased in hyaline membranes (HM). In some cases, HM were CD68 positive. The serum level of VEGF165 was up-regulated, while VEGF165 intensity in PC decreased and the HM appeared in alveolar spaces.
CONCLUSIONS
Sporadic positivity of HM for CD68 and decreasing of VEGF165 expression in EC proved that VEGF165 is produced by PC, destroyed macrophages, and extravasated serum.

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Hallazgos similares al COVID-19 en un caso fatal de neumonía intersticial descamativa asociada con glomerulonefritis por IgA en una niña de 13 meses de edad
Simona Gurzu, Catalin-Bogdan Satala, Lorena Elena Melit, Adrian Streinu-Cercel, Dan Otelea, Brandusa Capalna, Claudiu Ioan Puiac, Janos Szederjesi, Ioan Jung
Kompass Neumología.2021; 3(2): 69. CrossRef
COVID-19 Like Findings in a Fatal Case of Idiopathic Desquamative Interstitial Pneumonia Associated With IgA Glomerulonephritis in a 13-Month-Old Child
Simona Gurzu, Catalin Bogdan Satala, Lorena Elena Melit, Adrian Streinu-Cercel, Dan Otelea, Brandusa Capalna, Claudiu Ioan Puiac, Janos Szederjesi, Ioan Jung
Frontiers in Pediatrics.2020;[Epub] CrossRef

Case Report

Malignant Glomus Tumors of the Stomach: A Report of 2 Cases with Multiple Metastases.: Hyunjoo Lee, Yoon Seok Choi, Sang Cheul Oh, Jong Jae Park, Chul Whan Kim, Han Kyeom Kim, Insun Kim; Korean J Pathol. 2009;43(4):358-363.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.4.358

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Abstract PDF

Glomus tumors are mesenchymal neoplasms usually developing in the dermis or subcutis of the extremities. The majority of glomus tumors are entirely benign, and malignant glomus tumors are very rare, especially those arising in the visceral organs. Here, we are presenting two cases of malignant glomus tumor, initially diagnosed in the stomach by endoscopic biopsy. Case 1 was found in the stomach, right kidney, brain and humerus of a 65-year-old woman, and Case 2 in the stomach and liver of a 63-year-old man. Histologically, the tumor was composed of solid sheets and nests of round and short-spindle shaped tumor cells with vesicular nucleus and prominent nucleolus. The tumor cells were closely admixed with blood vessels of varying size. Immunohistochemically, the tumor cells showed diffuse and strong positive staining for smooth muscle actin and paranuclear, dot-like staining for synaptophysin, but negative for desmin, c-kit, CD34 and S-100 protein. These two are rare cases of a malignant glomus tumor with widespread metastases.

Citations

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Malignant gastric glomus tumor with heterochronous liver metastases: a case report and review of the literature
Shining Xu, Teng Xu, Yihao Zhi, Feng Dong, Chao Wu, Minhua Zheng
Journal of Medical Case Reports.2025;[Epub] CrossRef
Clinicopathologic features of gastric glomus tumor: A report of 15 cases and literature review
Minying Deng, Rongkui Luo, Jie Huang, Yuanlong Luo, Qi Song, Huaiyu Liang, Chen Xu, Wei Yuan, Yingyong Hou
Pathology and Oncology Research.2023;[Epub] CrossRef
Glomus Tumor of the Stomach: A Systematic Review and Illustrative Case Report
Andrea Pansa, Laura Samà, Laura Ruspi, Federico Sicoli, Ferdinando Carlo Maria Cananzi, Vittorio Quagliuolo
Digestive Diseases.2023; 41(1): 17. CrossRef
Locally Advanced Glomus Tumor of the Stomach With Synchronous Liver Metastases: Case Report and Literature Review
Fabio Frosio, Carmine Petruzziello, Elia Poiasina, Michele Pisano, Alessandro Lucianetti
Cureus.2023;[Epub] CrossRef
Gastric Glomus Tumor: A Clinicopathologic and Immunohistochemical Study of 21 Cases
Jun Lin, Juan Shen, Hao Yue, Qiongqiong Li, Yuqing Cheng, Mengyun Zhou, Yujiang Fang
BioMed Research International.2020;[Epub] CrossRef
Malignant glomus tumor of the gastric antrum with hepatic metastases: a case report and literature review
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Human Pathology: Case Reports.2018; 14: 81. CrossRef

Original Articles

Detecting Malignant Urothelial Cells by Morphometric Analysis of ThinPrep(R) Liquid-based Urine Cytology Specimens.: Bong Kyung Shin, Young Suk Lee, Hoiseon Jeong, Sang Ho Lee, Hyunchul Kim, Aree Kim, Insun Kim, Han Kyeom Kim; J Pathol Transl Med. 2008;19(2):136-143.; DOI: https://doi.org/10.3338/kjc.2008.19.2.136

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Abstract PDF

Urothelial carcinoma accounts for 90% of all the cases of bladder cancer. Although many cases can be easily managed by local excision, urothelial carcinoma rather frequently recurs, tends to progress to muscle invasion, and requires regular follow-ups. Urine cytology is a main approach for the follow-up of bladder tumors. It is noninvasive, but it has low sensitivity of around 50% with using the conventional cytospin preparation. Liquid-based cytology (LBC) has been developed as a replacement for the conventional technique. We compared the cytomorphometric parameters of ThinPrep(R) and cytospin preparation urine cytology to see whether there are definite differences between the two methods and which technique allows malignant cells to be more effectively discriminated from benign cells. The nuclear-to-cytoplasmic ratio value, as measured by digital image analysis, was efficient for differentiating malignant and benign urothelial cells, and this was irrespective of the preparation method and the tumor grade. Neither the ThinPrep(R) nor the conventional preparation cytology was definitely superior for distinguishing malignant cells from benign cells by cytomorphometric analysis of the adequately preserved cells. However, the ThinPrep(R) preparation showed significant advantages when considering the better preservation and cellularity with a clear background.

Citations

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Utility of Image Morphometry in the Atypical Urothelial Cells and High-Grade Urothelial Carcinoma Categories of the Paris System for Reporting Urinary Cytology
K.C. Sharan, Manish Rohilla, Pranab Dey, Radhika Srinivasan, Nandita Kakkar, Ravimohan S. Mavuduru
Journal of Cytology.2024; 41(3): 137. CrossRef
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Yong‐Moon Lee, Ji‐Yong Hwang, Seung‐Myoung Son, Song‐Yi Choi, Ho‐Chang Lee, Eun‐Joong Kim, Hye‐Suk Han, Jin young An, Joung‐Ho Han, Ok‐Jun Lee
Diagnostic Cytopathology.2014; 42(5): 384. CrossRef
A Comparison Between ThinPrep Monolayer and Cytospin Cytology for the Detection of Bladder Cancer
Ji Yong Kim, Hyung Jin Kim
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Cytological and Morphometric Study of Urinary Epithelial Cells with Histopathological Correlation
Asim Kumar Manna, Manisha Sarkar, Ujjal Bandyopadhyay, Srabani Chakrabarti, Swapan Pathak, Diptendra Kumar Sarkar
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Korean Journal of Pathology.2012; 46(1): 68. CrossRef

Genetic and Epigenetic Alterations of the Wnt/beta-catenin Signaling Pathway in Cancer of the Ampulla of Vater.: Gwang Il Kim, Jeong Boon Kim, Sang Bum Park, Young Sik Kim, Han Kyeom Kim, Bom Woo Yeom, Yang Seok Chae; Korean J Pathol. 2007;41(4):224-231.

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Abstract PDF: BACKGROUND
Carcinoma of the ampulla of Vater is rare and its pathogenesis is unclear. The role of epigenetic changes in the APC or CDH1, in the Wnt pathway, has not been reported in ampullary carcinomas.
METHODS
We performed immunohistochemistry on 73 sporadic ampullary carcinomas to identify Wnt-related molecules (APC, beta-catenin, E-cadherin, c-erbB2, cyclin D1) and examined mutations in the CTNNB1, loss of heterozygosity of 5q21, and the methylation status of the CpG island of APC and CDH1.
RESULTS
Thirteen tumors (17.8%) showed abnormal nuclear localization of beta-catenin; this was more prominent in the intestinal type than in the pancreaticobiliary type (p=0.01). The loss of APC correlated with the loss of beta-catenin or c-erb B2 (p<0.01). The prognosis was worse in the group with APC loss than when APC was maintained (p<0.05). There was no mutation identified in CTNNB1. Six (24%) out of 25 informative cases had 5q21 allelic loss. CpG island methylation in APC and CDH1 was detected in 33 (45.2%) and 29 (31.5%) cases, respectively.
CONCLUSIONS
The absence of mutations in CTNNB1 and the epigenetic alteration of APC and CDH1, might be characteristic changes in the Wnt/beta-catenin signaling pathway during the carcinogenesis of ampullary carcinomas.

The Correlation between the Proliferative Activity in Biopsied Specimen of Gastric Adenocarcinoma and the Pathologic Findings of Resected Specimen.: Hye Sun Kim, Jae Bok Lee, Se Min Kim, Jong Sang Choi, Han Kyeom Kim; Korean J Pathol. 1997;31(3):211-218.

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Abstract PDF: Studies on the correlation between proliferative activity of biopsied specimen and pathologic findings of resected specimen have been carried out to find the prognostic factors. To estimate the proliferative activity, 100 cases of biopsied specimen of gastric adenocarcinoma were tested for the PCNA (proliferating cell nuclear antigen) and the AgNOR (argyrophilic nucleolar organizer region) by the immunohistochemical and histochemical stainings, respectively. The resected tumors classified by histologic type, differentiation, depth of invasion, and nodal metastatic status were followed by cell cycle analysis using flow cytometry. The PCNA LI (labelling index) were higher in well or moderately differentiated tumors (P<0.01) than the poorly differentiated ones and the aneuploid tumors (P<0.05) more than in diploid ones. However, there were no correlations among histologic types, depth of invasion, nodal metastatic status and PCNA LI. The AgNOR counts were higher in advanced tumor than in the EGC (early gastric cancer) (P<0.01). In cases with nodal metastasis, most of them showed the AgNOR counts higher than those without nodal metastasis. There were no correlations between the AgNOR counts and the DNA ploidy, histologic type, or differentiation. High PCNA LI and high AgNOR counts were shown in cases with advanced tumors (P=0.000) and nodal metastasis (P<0.05). No correlation was shown with the histologic type or differentiation. The results show that proliferative activity of the biopsied specimen of gastric adenocarcinoma is correlated with the differentiation and the invasion depth of resected specimen. Especially, better correlation is obtained by analyzing both the PCNA LI and the AgNOR counts than by analyzing each.

Giant Cell Arteritis of the Spermatic Cord.: Seung Yeon Ha, Han Kyeom Kim, In Sun Kim; Korean J Pathol. 1992;26(6):638-640.

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Abstract PDF: Giant cell arteritis is a focal granulomatous inflammation of arteries of medium and small size that affects principally the cranial vessels, especially the temporal arteries, in older individuals. It appears to be a localized process; its significance apparantly depends on the organ affected. A 67-year-old man was admitted to hospital because of the left scrotal mass and pain lasting for 1 month. On physical examination, the hard masses were palpated at the superior part of the left epididymis without tenderness. Histologically, the spermatic cord showed granulomatous arteritis involving the small and medium sized arteries with a transmural inflammatory infiltrates centered on the inner media, and composed of lymphocytes, histiocytes, some eosinophils and multinucleated giant cells. The elastic tissue stain revealed the fragmentation of the internal elastic lamina along with numerous epithelioid histiocytes and giant cells.

Case Report

Acute Interstitial Pneumonia (Hamman-Rich Syndrome): An Autopsy Case.: Han Kyeom Kim, Ae Ree Kim, Min Ji Jeoung, Won Hee Seo, Jee yeoun Lee, Su Hyun Park; Korean J Pathol. 1997;31(4):366-374.

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Abstract PDF: Acute interstitial pneumonia is a fulminant disease of unknown etiology that usually occurs in a previously healthy person and produces the histologic findings of the organizing phase of diffuse alveolar damage. We experienced an autopsy case of acute interstitial pneumonia of unknown etiology. The patient was a 48 year old man who had been healthy and had not been exposed to organic dusts or other toxic materials. The chief complaints represented were dyspnea and a dry cough for several weeks before hospitalization, and the chest radiographs showed bilateral interstitial infiltrates. Patchy consolidation of air space was also identified and ground-glass attenuation similar to those described in ARDS was detected on high-resolution computed tomography. Steroid pulse therapy, mechanical ventilation, and antibiotics for superimposed bacterial infection were performed, but the symptoms did not improve and the patient died of generalized respiratory insufficiency and severe hypoxemia 2 1/2 months after hospitalization. At autopsy the macroscopic and microscopic findings were confined mainly to the lungs. On the whole, both lungs were firm in consistency and the external surface showed a cobblestone appearance. The cut surface showed almost complete replacement of the normal lung parenchyma with gray to yellow fibrous tissue with a little residual functional area remaining. The pathology of both open lung biopsy and autopsy tissue showed marked hyperplasia of type II pneumocytes, hyaline membrane formation, thickening of the alveolar wall due to extensive fibroblast proliferation, and relatively abundant young collagen deposition in the interstitium. An immunohistochemical stain for cytokeratin revealed epithelial hyperplasia and showed that the alveolar spaces were markedly shrunken by fibrous tissue.

Original Articles

Grading System for Gastric Epithelial Proliferative Diseases Standardized Guidelines proposed by Korean Study Group for Pathology of Digestive Diseases.: Hoguen Kim, So Young Jin, Ja June Jang, Woo Ho Kim, Sang Yong Song, Kyu Rae Kim, Eun Sil Yu, Hyung Sik Shin, Han Kyeom Kim, Jin Hee Sohn, Eun Kyung Hong, Youn Wha Kim, Jin Sook Jeong, Chang Jin Kim, Shin Eun Choi, In Suh Park, Chan Il Park, Yong Il Kim; Korean J Pathol. 1997;31(5):389-400.

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Abstract PDF: The assessment of epithelial changes in gastric mucosal biopsies has been one of the major problems caused by inconsistencies in and disagreements about nomenclature and interpretation. To resolve these issues, members of the Study Group for Pathology of Digestive Diseases reviewed microslides of 50 gastric lesions showing varying degrees of mucosal abnormality and reached the following consensus; 1) the proliferating gastric epithelium can be divided into hyperplastic and neoplastic; 2) the term "dysplasia" is reserved for the microscopic epithelial changes that are unequivocally neoplastic; 3) Biopsy specimens can be categorized as regenerative(negative for dysplasia), indefinite(questionable dysplasia), positive(positive for dysplasia) and overt carcinoma; 4) The positive category can be divided into two subgroups, high grade dysplasia and low grade dysplasia. Criteria for each grade are presented and discussed. We offer these guidelines for establishing the correct diagnosis of the gastric mucosal biopsy specimens and for prospective studies.

Immunophenotype of Thymic Epithelial Tumors According to the New World Health Organization Classification.: Sung Hye Park, Han Seong Kim, Han Kyeom Kim, Bong Kyung Shin, Seung Mo Hong, Jae Y Ro; Korean J Pathol. 2001;35(4):278-285.

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Abstract PDF: BACKGROUND
To identify the expression patterns and usefulness of various antibodies in making diagnoses and predicting prognoses, an immunohistochemical study was performed on thymic epithelial tumors (TETs).
METHODS
Forty-two cases of TETs were reclassified according to the new World Health Organization (WHO) classifications. CD3, CD5, CD79a, CD99, pan-, high- and low-molecular weight cytokeratins, EMA, vimentin, MIB-1 (Ki67) and p53 immunostaining were carried out.
RESULTS
There were two, twelve, eight, two, thirteen and one case for type A, AB, B1, B2, B3 and C, respectively. Combined B1/B2 and B2/B3 were 2 cases each. Fourteen cases (33.3%) had myasthenia gravis. CD99 was immunoreactive mainly in cortically derived lymphocytes, while CD3 and CD5 were immunoreactive in medullary-derived lymphocytes. CD5 immunoreactivity was negative in all thymic epithelial cells, except for one case of type B3. MIB-1 indices were highly expressed in cortical lymphocytes and some thymic epithelial cells, but did not show any correlation with grades. p53 in thymic epithelial cells was expressed in 6 (46%) out of 13 cases of type B3 and one case of type C, and it was negative in all other subtypes.
CONCLUSIONS
Only p53 was helpful for predicting high grades (B3 and C) (P<0.05). By MIB-1 indices, we could tell how many cortical immature lymphocytes were occupied in TETs, however, grading could not be achieved.

Normal Sizes and Weights of Internal Organs of the Korean Young Male Adults.: Chae Won Lee, Han Kyeom Kim; Korean J Pathol. 1986;20(1):71-76.

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Abstract PDF: In autopsy, the evaluation of the size and weight of th internal organs is very important for the understanding of the pathologic conditions. The normal data of the internal organs must have regard to size, weight, sex, age and body weight. There are many reports on the normal value of human organs in Japan and other Western countries. But there are some variations in normal value according to race, geographics and living standard. In Korea, Lee & Roh had reported on weights of various organs of Korean and their proportional weights to body weights in 1957, based upon autopsy records from 1929 to 1941. But, there has been many improvement in socioeconomic status during past half-century in this country. And the Korean body conditions have much improved. Upon the base of above consideration, normal data fit for present Korean is mandatory. We have analysed records of 45 cases of Korean young adults's autopsy cases which were performed from Jan. 1984 to Dec. 1985, and obtained following data. The results obtained are as follows: Heart : left ventricle thickness; 1.76+/-0.3 cm right ventricle thickness; 0.5+/-0.1 cm Aorta circumference; 6.1+/-0.5 cm Pulmonary a. circumference; 7.0+/-0.7 cm Weight : 338+/-54 gm Lung : size: left; length 23.3+/-2.78 cm, width 12.3+/-2.28 cm, thickness 6.4+/-1.55 cm right; length 24.1+/-2.65 cm, width 14.7+/-2.95 cm, thickness 6.6+/-1.31 cm Weight : left; 541+/-117 gm, right; 634+/-118 gm Liver : size: greatest transverse measurement; 28.5+/-2.7 cm vertical measurement; 16.6+/-1.74 cm great anterior-posterior diameter; 8.8+/-1.51 cm weight: 1,559+/-267 gm Spleen : length: 12.7+/-2.1 cm, breadth: 8.4+/-1.5 cm, thickness: 3.4+/-1.1 cm, weight: 155+/- 69.3 gm Pancreas : length; 16.7+/-2.8 cm, weight: 111+/-34.5 gm Kidney : size: left; length; 11.2+/-0.7 cm, width; 5.9+/-0.7 cm, thickness; 3.8+/-0.8 cm, thickness; 3.6+/-0.7 cm weight: left; 150+/-25 gm, right; 138+/-29 gm Brain : weight: 1,498+/-132 gm

Paleopathologic Analysis of a Mummified Pregnant Woman of Papyung Yoon's Family.: Woon Yong Jeong, Bong Kyung Shin, Chul Hwan Kim, Insun Kim, Woo Rim Kim, Kwang Sik Choe, Chang Sub Uhm, Juck Joon Hwang, Han Kyeom Kim; Korean J Pathol. 2004;38(6):394-400.

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Abstract PDF: BACKGROUND
A mummy is a dead body of a human being or an animal that has been preserved artificially or naturally from decaying. Because the natural environment of Korea isn't appropriate for mummification and Korean people haven't artificially made mummies, mummies were rarely studied in Korea.
METHODS
On September 6, 2002, a well-preserved female mummy was found in the grave of a family in Kyunggi-do. She was submitted to a thorough autopsy examination along with the review of genealogical documents.
RESULTS
The mummy died in winter. She was pregnant and the fetal head was observed at the vaginal orifice. The uterine wall was ruptured, and the peritoneum was discolored, probably by hemorrhage. Histologically, the gastric mucosa was well preserved. On the smear cytology of gastrointestinal material and the fluid from the coffin, pollens and parasitic eggs were observed. The woman seemed to be death from hypovolemic shock due to uterine rupture during the 2nd phase of labor.
CONCLUSION
From this case, we concluded the causes of the woman's mummification included the cold and dry circumstance at the time of her death, and the thick mortared wall of the grave that completely isolated the body from the outside.

Case Report

Metastatic Germinoma of Spleen from Perichiasmal Area: A Case Report .: Bong Kyung Shin, Min Kyung Kim, Han Kyeom Kim, Yang Seok Chae, Nam Hee Won, Insun Kim; J Pathol Transl Med. 2001;12(1):61-65.

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Abstract PDF: A 20-year-old young man who had undergone treatment for a suprasellar/perichiasmal tumor 2 years before, was presented with a huge palpable splenic mass. A fine needle aspiration cytology from the splenic mass showed dissociated large pleomorphic tumor cells having irregular nuclear outline, coarse chromatin, and one or two macronucleoli, and scattered small lymphocytes in fine granular background. Above cytologic findings were regarded as the characteristics of germinoma. Differential diagnosis from the large cell lymphoma of spleen was emphasized.

Original Articles

Immunohistochemical Study for p53 and hsc70 in Transitional Cell Carcinoma of the Urinary Bladder: Correlation with Histologic Grade, Clinical Stage and DNA Ploidy Pattern.: Hyuni Cho, Sung Jin Cho, Han Kyeom Kim, Yang Seok Chae; Korean J Pathol. 1995;29(6):766-775.

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Abstract PDF: Transitional cell carcinoma of the urinary bladder is the most common cancer of the genitourinary tract in Korea and its prognosis is determined by the histologic grade and clinical stage present at initial diagnosis. Recently, an extensive search for a more objective and reproducible method to evaluate the proliferation activity of cancer cells has been done. The p53 gene is located on the short arm of the chromosome 17 and acts as a cancer suppressor gene. Mutant p53 gene induces malignant transformation. Recent studies reveal that the level of mutant p53 protein is elevated in some human tumor and many diverse transformed cell lines. Heat shock proteins(HSPs) are present constitutively in normal cells, where they play an important role in normal cell metabolism. In mammalian cells, they are induced by a variety of physical and chemical stimuli. A protein that belongs to the hsp70 family, called hsc70, is only slightly heat inducible and is found at a higher level in growing cells than in the resting cells. The mutant p53 protein binds with hsc70 and the p53-hsc70 complex has functional significance in the transforming capacity of the mutant p53. We investigated the correlation between the p53 and hsc70 by immunohistochemical methods and with better defined prognostic indicators such as histologic grade, clinical stage, and DNA ploidy pattern in 42 transitional cell carcinomas of the urinary bladder. The results are summarized as follows. p53 expression rate was higher in the DNA aneuploid group than in the DNA diploid group(p=0.061), but there was no significant difference in the histologic grade(p=0.861) or clinical stage(p=0.154). The higher the hsc70 expression rate was, the poorer the tumor differentiation(p=0.000) and the deeper the invasion(p=0.001). The aneuploid group showed a higher hsc70 expression rate than the diploid group(p=0.017). 27 of 42(64.3%) carcinomas showed positivity of both p53 and hsc70. Though statistically insignificant, their correlation showed a relatively low correlation coefficient (P=0.059). In conclusion, we suspect that p53 and hsc70 are closely correlated to each other by comparing the results of this immunohistochemical study, and hsc70 will be a useful prognostic marker in transitional cell carcinomas of the urinary bladder after sufficient follow up studies are performed.

Infantile Myofibromatosis(Congenital Generalized Fibromatosis): Associated with multiple congenital malformations and basaloid follicular hamartomas in the skin.: Eun Sook Nam, Yoo Hun Kim, Han Kyeom Kim, Insun Kim, Je Geun Chi; Korean J Pathol. 1995;29(6):776-782.

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Abstract PDF: Infantile myofibromatosis with systemic involvement is a very rare disease and is characterized by numerous nodules composed of spindle cells of a myofibroblastic nature. There are often disseminated throughout the subcutis, muscle, skeleton and viscera. We report an autopsy case of infantile myofibromatosis in a stillborn female fetus of 32 weeks of gestation. The nodules, Imm to 2 cm, were found over the whole body and viscera. The involved viscera were the heart, tongue, esophagus, gastrointestinal tract, portal areas of the liver, spleen anc pancreas. There were also associated malformations, viz., frontal meningoencephalocele, flexion defer-mities, syndactyly, cleft palate, agenesis of corpus callosum, pachygyria, diaphragmatic hemia, renal hypoplasia, etc. Multiple basaloid follicular hamartomas of the skin were noted on the face and extremeties. There are no previous reports in the literature of infantile myofibromatosis in conjunction with the above skin lesion and congenital malformations.

Case Report

Fine Needle Aspiration Cytologic Findings of Gastric Inflammatory Myofibroblastic Tumor: A case report.: Ji Hye Lee, Bong Kyung Shin, Chung Yeul Kim, Seong Jin Cho, Han Kyeom Kim, In Sun Kim; J Pathol Transl Med. 2001;12(2):117-120.

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Abstract PDF: Inflammatory myofibroblastic tumor, histologically characterized by the presence of bland-looking spindle cells and infiltration of chronic inflammatory cells, is extremely rare in the gastric wall. We report a case of gastric inflammatory myofibroblastic tumor in a 27-month-old boy. The fine needle aspiration biopsy from the mass showed loose clusters or scattered spindle cells and inflammatory cells, predominantly of lymphocytes and plasma cells. The spindle cells resembled fibroblasts or myofibroblasts. Differential diagnosis from benign and malignant diseases involving abdominal cavity was discussed.

Editorial

The Korean Journal of Pathology is Selected for Coverage in Science Citation Index Expanded and Journal Citation Reports by Thomson Reuters.: Jeong Wook Seo, Kyung Ja Cho, Han Kyeom Kim, Dae Young Kang; Korean J Pathol. 2008;42(3):131-133.

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Abstract PDF: No abstract available.

Case Report

Breast Mass as a Manifestation of Ectopic Paragonimiasis: A case report.: Yung Suk Lee, Seung Yeon Ha, Hyun I Cho, Han Kyeom Kim, Jung Won Bae, In Sun Kim; Korean J Pathol. 1993;27(6):656-658.

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Abstract PDF: Paragonimus westermani can cause extrapulmonary parasitism in various sites such as abdominal organ, brain, eye, periorbital tissue, heart and pericardium, mediastinum, and subcutaneous tissue. We experienced a case of subcutaneous paragonimiasis involving the breast. The lesion exhibited chronic granuloma with scattered eggs of paragonimus westermani. The adult worm was not found within the lesion which should be disintegrated a year ago by praziquantel treatment. This relatively rare involvement of ectopic paragonimiasis should be differentiated from breast malignancy.

Original Article

Age Estimation of Mummies by Dental Attrition: Application of Three-dimensional CT Images.: Kwang Ho Jeong, Han Kyeom Kim, Chang Lyuk Yoon, Seong Jae Lee, Seung Yeon Ha; Korean J Pathol. 2008;42(5):299-305.

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Abstract PDF: BACKGROUND
Because of the rarity of mummies in Korea and the difficulty in obtaining samples from mummies, studies to determine the ages of mummies are uncommon in Korea. This study was performed to determine the ages of mummies using the information obtained by nondestructive methods to minimize damages to the mummies. METHODS: Three mummies excavated between 2002 and 2004 were used. Three-dimensional reconstructed images of the total teeth were obtained by CT scanning. The age at death was determined according to the 'Age Estimation Table of Dental Attrition' as developed by Takei. Three teeth were extracted from each of three mummies and examined grossly and microscopically by serial sections using the Gustafson-Johanson method. RESULTS: The ages at death of the three mummies estimated by the Takei method were 23.57 years (Yoon mummy), 51.01 years (Bong mummy), and 64.45 years (Black mummy). These results were similar to the ages determined by the Gustafson method. CONCLUSION: Age determination method using a CT scan and three-dimensional reconstruction may be a valuable method because it minimizes the damages to valuable mummies and it gives reliable data similar to that obtained by other standard methods.

Case Report

Liposclerosing Myxofibrous Tumor in Tibia: A Case Report and Review of the Literature.: Jung Woo Choi, Young Seok Lee, Ju Han Lee, Han Kyeom Kim, Bom Woo Yeom, Jong Sang Choi, Hong Chul Lim, Chul Hwan Kim; Korean J Pathol. 2005;39(3):207-210.

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Abstract PDF: Liposclerosing myxofibrous tumor (LSMFT) is a benign fibro-osseous lesion that is characterized by a complex mixture of histologic elements, including its fibrous dysplasia-like features and its lipoma, myxofibroma, xanthoma and pseudo-Paget's bone patterns. However, this lesion is considered by some researchers as a variant of fibrous dysplasia or as the non-specific end result of degenerative change, while it is considered by others as a definite clinicopathologic entity. Here, we report on a case of LSMFT occurring in tibia, which is a very uncommon location for this tumor, and we review the related literatures. The case presented here shares features with those described for LSMFT, except for the location of this tumor. We believe that more studies on a larger scale that compare LSMFT with other benign bone lesions, including fibrous dysplasia, are required to clarify the origin and behavior of this lesion.

Original Articles

The Expression of TGF-beta1 and TGF-beta Receptor I in Human Lung Cancer.: Hye Kyung Ahn, Young Hee Choi, Jung Weon Shim, Young Euy Park, Han Kyeom Kim, Jong Sang Choi, Joung Ho Han; Korean J Pathol. 1998;32(1):9-20.

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Abstract PDF: A majority of human lung cancer cell lines have developed resistance to growth inhibition via the activation of transforming growth facter-beta (TGF-beta). Previous studies have reported that growth inhibition of TGF-beta is linked to the expression of transforming growth factor-beta receptor type I (TGF-betaRI). Immunohistochemical studies of TGF-beta1 and TGF-betaRI have been carried out in 43 cases of lung neoplasm; including 25 cases of squamous cell carcinoma, 13 cases of adenocarcinoma, 2 cases of adenosquamous cell carcinoma, and 1 case each of undifferentiated carcinoma, small cell carcinoma and neuroendocrine carcinoma. Reverse transcriptase polymerase chain reaction (RT-PCR) for TGF-beta1 mRNA was also performed in 40 cases of tumors and 14 control cases of normal parenchyme. Immunohistochemically, TGF-beta1 and TGF-betaRI expression were noted in the cytoplasm of all type of tumor cells. The staining intensity and areas were examined and scored from 0 to 5. As a whole, TGF-beta1 staining scores in the neoplastic lesions were higher than that of the adjacent normal parenchyme, bronchial epithelium or alveolar epithelium. However, TGF-betaRI staining scores were generally lower than that of the adjacent normal components. The TGF-beta1 mRNA showed a higher percentage of expression in tumors than in normal control. Tumor size, lymph node metastasis, histological differentiation and histological type of tumors did not correlated with the staining score of TGF-beta1 and TGF-betaRI. These results indicate that although various types of human lung carcinoma cells produce TGF-beta1, they show a reduction in TGF-betaRI, resulting in an escape from growth inhibition by TGF-beta1.

Management and Ethics of Biobank; Biorepository.: Bong Kyung Shin, Jung Woo Choi, Hyunjuu Lee, Aree Kim, Insun Kim, Han Kyeom Kim; Korean J Pathol. 2005;39(6):372-378.

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Abstract PDF: Research access to a large number of high-quality biospecimen, adequately annotated and ethically acquired, is critical to an improved understanding of disease and ultimately new development of effective diagnostic markers and therapeutic targets. Therefore, the importance of biobanking is widely recognized within the life science and healthcare communities. Resolution of the ethical issues, including informed consent, confidentiality and institutional review board approval, are probably the most important task to every biobank or biorepository. In Korea, the new, very strict ethical act on research, issued in 2005, requires researchers as well as biorepositories to know how they use or run a biorepository ethically without damaging the right of human subjects who gave the repository their biospecimen.

A Study of Lectin Histochemistry in Allergic Contact Dermatitis of Guinea Pig.: Joung Ho Han, Eun Sook Nam, Young Chul Kye, Han Kyeom Kim, Seung Yong Paik; Korean J Pathol. 1991;25(4):281-290.

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Abstract PDF: The alterations in the localization of keratinocyte membrane glycoconjugates in allergic contact dermatitis were investigated in guinea pig skin treated with topical application of 2.4-dinitro-chlorobenzene. We employed the avidin-biotin complex(ABC) method for the detection of localization of 10 commercially available lectins labelled with biotin: Con-A, SBA, WGA, DBA, UEA-1, RCA-1, PNA, HP, MPA, and ECA. Staining with WGA showed a remarkably decreased intensity in basal and spinous layers of the allergic skin in comparison to those of the control skin, suggesting loss of terminal sialic acids in cell membrane glycoconjugates. The other lectins showed no remarkable difference in the staining patterns between the normal and the allergic ski. The results suggest that epidermal cell membrane glycoconjugates undergoes selective perturbations in acute allergic contact dermatitis, and that the keratinocytes might be an active part of the cutaneous immune system.

Mucinous Tumors of the Appendix Associated with Mucinous Tumors of the Ovary and Pseudomyxoma Peritonei: A Clinicopathologic Analysis of 5 Cases Supporting an Appendiceal Origin.: Eung Seok Lee, Han Kyeom Kim, In Sun Kim; Korean J Pathol. 1998;32(2):131-137.

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Abstract PDF: Pseudomyxoma peritonei often have synchronous appendiceal and ovarian mucinous tumors. There has been considerable debate as to whether the ovarian tumors are secondary to the appendiceal tumor or they are independent primary ovarian tumors. It is important to reveal the primary site for treatment and prognosis of a patient. Five cases of synchronous mucinous tumors of the ovary and appendix were studied. Four cases had pseudomyxoma peritonei and pseudomyxoma ovarii. The ovarian tumors were bilateral in two cases, right in two, and left in one. The ovarian tumors were four mucinous cystadenoma of borderine malignancy and one mucinous cystadenocarcinoma, and the appendiceal tumors consisted of four mucinous tumors of borderline malignancy and one mucinous adenocarcinoma. The histology of the ovarian and appendiceal tumors was similar. Rupture of the tumor was seen in all appendiceal tumors and two ovarian tumors. It has been reported that cytokeratin 7 is a useful marker for distinguishing primary ovarian neoplasms from metastases of intestinal origin. All ovarian and appendiceal tumors showed positive reaction for broad-spectrum cytokeratin, but negative for cytokeratin 7. Based on the clinicopathologic and immunohistochemical features, it should be considered that the appendiceal tumors are primary and ovarian tumors are secondary in the synchronous presentation of the ovarian and appendiceal mucinous tumors.

Case Reports

Plexogenic Pulmonary Arteriopathy in Congenital Heart Disease: A Report of Two Cases.: Seung Yeon Ha, Kook Yang Park, Hyun Yee Cho, Young Ha Oh, Jae Gul Chung, Dong Hae Chung, Chung Yeul Kim, Han Kyeom Kim; Korean J Pathol. 2002;36(6):412-415.

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Abstract PDF: Hypertensive pulmonary vascular disease can develop in those cases of congenital cardiac shunt in which critical levels of pulmonary artery pressure and flow are reached and exceeded. We have experienced two cases of plexogenic arteriopathy in complex congenital heart disease and tried to evaluate of distribution of arterial lesions by total mapping of the explanted lung. Case 1 and 2 were 12-year-old boy and 36 year-old man. They were treated with combined heart-lung transplantation. Mapping of the both lungs was done, and graded according to Heath and Edward's grading scheme. The elastic pulmonary artery was tortuous, dilated and aortic configuration. Both lungs showed mostly grade 3. Plexiform lesion or veinlike branches of hypertrophied muscular arteries arosed in a lateral branch of a muscular artery that might be proximal to an area of occlusion. Comprising the right and left lung, the right was more severe than the left. By getting closer to the distal part, the grade tended to increase to 4 to 5. By analyzing the pulmonary lobe, severe pulmonary hypertension of grade 4 or 5 was comparatively disseminated throughout the right lung. On the other hand, in the left lung, the grade of the lower lobe was higher than that of the upper lobe, and within the upper lobe, there was a tendency for the grade of inferior segment to be higher than that of the corresponding apical segment.

Follicular Lymphoma with Monoclonal Plasma Cell Differentiation: A Case Report.: Hyun chul Kim, Young Seok Lee, Jung woo Choi, Ae ree Kim, Bom Woo Yeom, Han kyeom Kim, In sun Kim; Korean J Pathol. 2006;40(2):151-155.

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Abstract PDF: We present a case of recurrent follicular lymphoma with an extensive plasma cell component involving infra-auricular lymph nodes in a 64 year-old woman. Immunohistochemical staining showed a strongly positive reaction of the follicles with CD20, bcl-2, bcl-6, CD10 and CD21 on the first biopsy specimen. The intrafollicular and interfollicular plasma cells showed monoclonality for IgG heavy chain and lambda light chain. The histological and immunohistochemical findings in the recurrent tumor were identical with those of the original. Discussion is focused on the importance of the differential diagnosis between reactive lymphoid hyperplasia and other lymphomas having plasmacytic differentiation.

Original Articles

Gastrointestinal Polyposis in Koreans: A Nationwide Survey of Clinicopathologic Analysis of 112 Surgically Resected Cases.: Mee Soo Chang, Hoguen Kim, Woo Ho Kim, Chan Il Park, Eun Kyung Hong, Han Kyeom Kim, In Soo Suh, Byung Kee Kim, Ja June Jang, Woon Sub Han, Hyung Sik Shin, So Young Jin, Dae Young Kang, Yong Il Kim; Korean J Pathol. 1998;32(6):404-412.

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Abstract: Gastrointestinal polyposis (GIP) is a rare disease characterized by formation of the numerous polyps in the gastrointestinal tract and presenting several extraintestinal manifestations. Most of the diseases are transmitted in an autosomal dominant pattern. In Korea, the epidemiological study as well as the pathological analysis of the GIP is not well established. We therefore analysed 38 items of GIP using surgically resected specimens. The materials in this study were collected from the 12 institutions and case reports in Korean literature between 1980 and 1991. The clinicopathologic findings were reevaluated by several members of the study group for gastrointestinal pathology. The results are as follows: (1) A total of 112 cases were included in this study: 83 cases were collected from 12 institutions and 29 cases were collected from Korean literature. The cases were classified as familial adenomatous polyposis (FAP), 59 cases; Gardner's syndrome, 3 cases; juvenile polyposis, 12 cases; Peutz-Jeghers syndrome, 35 cases; multiple colonic adenomas, 3 cases. (2) Among 59 cases of FAP, the range of age at operation was 14 to 61 years, and a family history was positive in 25 cases. The number of polyps in colorectum was 100~8,000. Of the 37 cases in which the examination of polyp density was available, 16 cases (43%) showed the highest density in the rectum and the sigmoid colon. The carcinomatous change within polyp(s) was present in 18 cases (31%), and associated advanced single or multiple colonic carcinomas existed in 37 cases (63%). Twenty-six (45%) tumors out of total 58 carcinomas were in the rectum. Twenty-five patients were evaluated for the upper gastrointestinal lesions, and 11 patients (44%) had pathologic lesions; multiple fundic gland polyps in 3 cases (12%), gastric and duodenal adenomas in 2 cases (8%), gastric adenomas in 2 cases (8%), duodenal adenomas in 2 cases (8%), gastric carcinoma and adenoma in 1 case (4%), gastric carcinoma in 1 case (4%). (3) Among 3 cases of Gardner's syndrome, the range of age at operation was 25 to 31 years, a family history was identified in 2 cases. One case was associated with an advanced colonic carcinoma and carcinomatous change within polyp. Extra gastrointestinal lesions were sebaceous cyst, epidermal cyst, osteoma and desmoid tumor. (4) Among 12 juvenile polyposis, the range of age at operation was 8 to 51 years and 5 patients had a family history. The carcinomatous change within polyp was found in 2 cases (17%) and associated advanced colonic carcinoma was in 4 cases (33%). The associated different type of polyps was tubular adenomas in 9 cases (75%), hyperplastic polyps in 4 cases (33%) and villous adenomas in 2 cases (17%). (5) Among 35 Peutz-Jeghers syndrome, the range of age at first operation was 6 to 42 years, family history was positive in 11 cases. The carcinomatous change within polyp was found in 1 case (3%), and associated advanced colonic carcinoma in 1 case (3%). The epithelial misplacement was observed in 4 cases (11%), and tubular or villous adenomatous feature in 4 cases (11%). In summary, the most frequent GIP for the surgical resection in Korea is FAP and the FAP is associated with high incidence of coexisting advanced and intramucosal carcinomas. Hamartomatous polyposis syndromes, such as juvenile polyposis and Peutz-Jeghers syndrome are another frequent disease for the surgical resection and are also associated with an increased risk of cancer.

Quantitative Nuclear Characteristics of Lung Cancer Cells Using Image Analysis.: Moon Kyoung Kim, Chung Yeul Kim, Woon Yong Jeong, Ji Hye Lee, Eung Seok Lee, Seung Yeon Ha, Young Sik Kim, Han Kyeom Kim, In Sun Kim; Korean J Pathol. 2003;37(2):115-120.

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Abstract PDF: BACKGROUND
The usefulness of quantitative nuclear image analysis in the classification of lung carcinoma is widely investigated and published. In this study, we tried to measure the nuclear characteristics of primary lung carcinomas by image analysis and to find the possibility of differential diagnoses.
METHODS
Seventeen cases of adenocarcinomas (not including bronchioloalveolar carcinoma), seven of bronchioloalveolar carcinomas, eight of large cell neuroendocrine carcinomas, five of small cell carcinamas, and 26 of squamous cell carcinomas were analysed. Three different images of each case were captured by digital camera, and we analyzed the nuclear area, perimeter, circularity, and density using the Optimas 6.5 Image Analyser software package. Statistical analyses were done using the statistical program STATISTICA kernel release 5.5.
RESULTS
The mean nuclear area was 0.52+/-0.25micrometer2 in the adenocarcinomas, 0.50+/-1.82micrometer2 in the squamous cell carcinomas, 0.45+/-0.20micrometer2 in the large cell neuroendocrine carcinomas, 0.42+/-0.16micrometer2 in the bronchioloalveolar carcinomas, and 0.31+/-0.12micrometer2 in the small cell carcinamas. The nuclear area was significantly different between the small cell carcinomas and the non-small cell carcinomas (p<0.01) and between the adenocarcinomas and the bronchioloalveolar carcinomas (p=0.02). The mean nuclear perimeter was 3.36+/-0.92micrometer2 in the adenocarcinomas, 3.24+/-0.67micrometer2 in the squamous cell carcinomas, 3.16+/-0.82micrometer2 in the large cell neuroendocrine carcinomas, 3.05+/-0.80micrometer2 in the bronchioloalveolar carcinomas, and 2.54+/-0.62micrometer2 in the small cell carcinamas. The nuclear perimeter was significantly different between the small cell carcinomas and the non-small cell carcinomas (p<0.04). The nuclear circularity showed no statistical difference. Nuclear density was the highest in the squamous cell carcinomas, and the lowest in the small cell carcinomas. The large cell neuroendocrine carcinomas showed the lowest standard deviation in nuclear density.
CONCLUSION
The analysis of nuclear characteristics using an image analyser can be used as an objective method in the classification of lung carcinoma.

Case Reports

Pulmonary Alveolar Proteinosis accompanied by Osseous Metaplasia: A case report.: Ae Ree Kim, Hyun I Cho, Han Kyeom Kim, Jong Sang Choi, In Sun Kim; Korean J Pathol. 1994;28(5):547-549.

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Abstract PDF: The authors experienced a case of pulmonary alveolar proteinosis. A 58-year-old woman presented with 6 months duration of cough sputum and multiple patch mottled densities in both lung fields. Major histologic finding was filling of the alveoli by Periodic-Acid-Schiff-positive proteinaceous material with maintenance of normal alveolar architecture. Osseous metaplasia was seen in the alveolar space, focally. Ultrastructural study revealed numerous lamellar bodies in alveolar spaces. The immunohistochemical study using antibody to surfactant apoprotein revealed positive reaction in proteinaceous material.

Multiple Well Differentiated Fetal Adenocarcinoma of the Lung: A Case Report .: Kwang Il Kim, Joo Han Lee, Jeong Seok Mun, Han Kyeom Kim; J Pathol Transl Med. 1997;8(1):69-75.

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Abstract PDF: Well differentiated fetal adenocarcinoma of the lung is a subtype of pulmonary blastoma. In this report, CT-guided fine needle aspiration smears were performed at the right upper lobe of the lung in a 45 year-old male patient who had the smoking history of one pack per day for 25 years. The smears disclosed round, papillary, and tubular patterns of cell clusters. The individual cells had relatively uniform, small to medium sized nuclei without nucleoli, and showed vesicular or eosinophilic cytoplasm with indistinct cell border. The morules were seen in the central area of papillary clusters. They were composed of two cell types, outer single layered cuboidal cellular lining and central three-dimensional cluster of cells simulating fetal lung. These cytologic features need to be differentiated from usual pulmonary adenocarcinoma, carcinoid, and pulmonary blastoma. On histologic findings, the tumor arised in the bronchial epithelium. And the tumor cells had abundant intracytoplasmic glycogen with neuroendocrine feature on histochemical study. In addition, the multiplicity of this tumor is the unique point comparable to the previous reports.

Original Articles

Histopathologic Findings, and p53 and K-ras Mutational Analysis in Biopsy Specimens Using Fluorescence Bronchoscopy.: Young Sik Kim, Seol Hee Park, Myung Hee Jung, Eun Chang Choi, I Yong Park, Han Kyeom Kim, Insun Kim; Korean J Pathol. 2000;34(8):550-558.

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Abstract PDF: A fluorescence bronchoscope system has been developed for detecting early lung cancer including dysplasia and carcinoma in situ. To determine the histologic findings and genetic alterations of the lung tissues, which were biopsied by the fluorescence bronchoscope, we analyzed 104 specimens from 62 heavy smokers for their histopathology, cell proliferation index, and genetic mutations of p53 and K-ras. We used immunohistochemistry for MIB-1 and p53, and PCR-SSCP and direct DNA sequencing for p53 and K-ras. The histology was variable from reactive conditions to invasive cancers, and consisted of basal cell hyperplasia (26.9%), dysplasia (4.8%), carcinoma in situ (1.9%), squamous cell carcinoma (7.7%), adenocarcinoma (4.8%), and small cell carcinoma (10.6%). The cellular proliferation index of the lesions increased as their aggressiveness increased. p53 and K-ras mutations were detected in 33.7% and 14.4% of all tissues, respectively. In dysplasia, p53 and K-ras mutations were observed in 3 of 5 and in 2 of 5 tissues, respectively. However, these genetic alterations were not found in carcinoma in situ. Interestingly, 28.6% of basal cell hyperplasia showed p53 mutations. In conclusion, these data suggest that the biopsy specimens using fluorescence bronchoscopy show variable histologic findings, ranging from reactive conditions to invasive cancers. In addition, some of the dysplastic lesions are related to p53 and K-ras mutations, although these genetic alterations are also seen in basal cell hyperplasia.

Fine Needle Aspiration Cytology of Mucoepidermoid Carcinoma of the Salivary Gland.: Jeong Seok Moon, Hwa Eun Oh, Joo Han Lee, Aee Ree Kim, Chul Hwan Kim, Han Kyeom Kim, Mee Ja Park, Nam Hee Won; J Pathol Transl Med. 1997;8(2):135-142.

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Abstract PDF: PURPOSE: There is no specific treatment guidelines for Henoch-Schonlein (HS) nephritis. Therefore we performed this study to observe the effect of long term steroid therapy combined with azathioprine METHODS: Treatment protocols; 1) Steroid pulse therapy: methylprednisolon 30 mg/kg/dose, maximum 1 gm, intravenously 6 times for alternate day. 2) Oral steroid was given 2 mg/kg/day for 1 month, 1 mg/kg/day for following I month and alternate day oral steroid combined with azathioprine 2 mg/kg/day for 2 years. RESULTS: Time period from HSP to onset of HS nephritis was between 2 weeks to 5 months with mean 7.4+/-7.4 weeks. Clinical remission were seen in 4 cases out of 5 (80%). Mean time period with disappearance of proteinuria and microscopic hematuria were 5+/-2.4 month and 13.3+/-2.9 month respectively. On pathologic findings by ISKDC, 3 cases were grade IIIb, 2 cases were grade IV in first kidney biopsies and showed pathologic improvement in follow up kidney biopsies after 2 years treatment. CONCLUSION: As there no definitive treatment for HS nephritis so far, our study of long term oral steroid therapy with azathioprine was effective in clinical and histologic aspect. Therefore further study in HS nephritis with in a large group will be needed in the future.

Case Report

Pregnancy Luteoma of the Ovary in a Primiparous Woman: A case report.: Chul Hwan Kim, Han Kyeom Kim; Korean J Pathol. 1992;26(4):417-419.

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Abstract PDF: Pregnancy luteoma is composed of a single or multiple nodules of large lutenized cells that develop during pregnancy but involute during the puerperium. This lesion is usually an incidental finding at the time of cesarean section or postpartum tubal ligation. Microscopically, this tumor is difficult to be differentiated from various types of sex-cord stromal tumors including Leydig cell tumor, luteinized thecoma, adult or juvenile granulosa cell tumors with luteinization, and lipoid cell tumor. We report a case of pregnancy luteoma in a 34-year-old primipara without virilizing symptoms at the time of cesarean section in the right ovary. The mass measured 5x4.5x3.5 cm and 60 gm in weight. The cut surface was homogeneously yellow-orange with mulitple hemorrhagic spots. Microscopically, the tumor revealed solid, trabecular, or microcystic pattern of large granular eosinophilic luteinized cells and somewhat large nuclei with prominent nucleoli. Differentiation from Leydig cell tumor and juvenile granulosa cell tumor was difficult in this case.

Original Articles

Fine Needle Aspiration Cytology of the Breast Lesions: Application of the Masood's Scoring System.: Ae Lee Kim, Hye Sun Kim, Han Kyeom Kim, Nam Hee Won, Mee Ja Park, Bum Hwan Koo; J Pathol Transl Med. 1998;9(1):45-54.

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Abstract PDF: Fine needle aspiration cytology is considered as a useful diagnostic procedure in management of patients with breast lesions. This study was undertaken to evaluate the scoring system of Masood in the interpretation of breast aspirates, to establish the most useful cytologic criteria for the diagnosis of breast lesions, and to subclassify the benign breast diseases. To assess the feasibility of a cytologic grading system, 57 cases of benign breast disease, 61 cases of malignant breast disease were studied, respectively. The aspirates were evaluated for the cellular arrangement, the degree of cellular pleomorphism and anisonucleosis, and the presence of myoepithelial cells and nuceoli. Values ranging from 1 to 4 were assigned to each criterion and the sum of the individual values was made for each case. The presence of stroma, apocrine metaplasia, foamy histiocytes and inflammatory cells, background of the smear, and cellularity were also evaluated. Cut-off value of the scoring system of Masood between benign and malignant lesion was 15. Among the cytologic criteria, cellular arrangement, presence of myoepithelial cells, nucleoli, and stroma, status of chromatin pattern, and background of smear were useful criteria in the differentiation between benign and malignant lesions. Application of the scoring system of Masood does not always make the accurate diagnosis and the subclassification of benign breast disease.

Immunohistochemical Study of Heat Shock Protein(HSP) and Estrogen Receptor(ER) in the Normal Endometrium and in Adenocarcinoma of the Endometrium.: Hyuni Cho, Aeree Kim, Yung Suk Lee, Han Kyeom Kim, Insun Kim; Korean J Pathol. 1995;29(2):205-211.

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Abstract PDF: Heat shock protein(HSP), first found in the MCF-7 human breast tumor cell line is one of the estrogen-regulated proteins and its synthesis is stimulated by estradiol. In this study, immunohistochemical staining was done for estrogen receptor(ER) and HSP on formalin-fixed, paraffin-embedded tissue sections in twelve normal cyclic and twenty carcinomatous endometria. 1) During the proliferative and early secretary phases, the nuclei of surface and glandular epithelial cells and stromal cells had moderate to strong staining for ER, whereas during the mid and late secretary phases, the glandular epithelial and stromal cells had weak staining for ER. The surface epithelial cells had positive staining of variable intensity. 2) From the early proliferative to mid secretary phases, the glandular and surface epithelial cells showed a positive reaction of variable intensity for HSP. In the late secretary phase, the glandular and surface epithelial cells showed a weak positive or a negative reaction for HSP. During the menstrual cycle, the stromal cells remained negative for HSP. 3) In adenocarcinomas of the endometrium, 8 of 11 (72.7%) well differentiated carcinomas were positive for both ER and HSP, while only 3 of 9(33.3%) moderately and poorly differentiated carcinomas were positive for ER and HSP. In conclusion, ER and estrogen-regulated heat shock protein(HSP) were closely related in normal and carcinomatous endometria and the reactivity was decreased according to poor differentiation.

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