Journal of Pathology and Translational Medicine

Case Report

Epidermoid Cyst of the Ovary: Two case reports.: Hyuni Cho, Yu Hoon Kim, Eun Suk Nam, Insun Kim; Korean J Pathol. 1995;29(6):811-814.

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Abstract PDF: Two cases of epidertnoid cyst of the ovary are added to the ten reported in the literature. This rare lesion is usually an incidental finding. Its main interest is in its histogenesis, which includes metaplasia of the coelomic surface epithelium, monophyletic development of teratoma, and metaplasia of the rete ovarii. We investigated two cases of epidertnoid cyst. Histologic examination of the cysts showed a thin lining of mature keratinizing squamous epithelium rectum: unaccompanied by skin appendages or other teratomatous elements.

Original Article

Characterization of Principal Component Cell of DMBA induced Rat Malignant Fibrous Histiocytoma With Cell Culture and Cloning.: Myeng Sun Park, Hae Jin Jeong, Man Ha Huh; Korean J Pathol. 1997;31(6):574-585.

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Abstract PDF: This experiment was performed to elucidate the cytologic origin of chemically induced MFH in Wistar rats. The tumor was produced by injections of DMBA(9,10-dimethyl-1,2-benzanthracene). With the produced MFH, cell culture and cloning were performed, followed by establishment of a cell strain, which was investigated by immunohistochemical and electron microscopic studies. The results were as follows. A) By immunohistochemistry of the tumor tissue, fibroblastic cells were positive for MEP-1(specific antibody for fibroblastlike cell of MFH, Takeya, 1993) and Anti-hPH(beta)(Anti-prolyl 4-hydroxylase beta), but negative for TRPM-3 and F4/80. Histiocytelike cells were positive for TRPM-3 and F4/80, but negative for MEP-1 and Anti-hPH(beta). In immunoelectron microscopy, normal spleen macrophage showed linear reactivity in cell membrane for TRPM-3, whereas histiocytelike cells of the tumor disclosed negative reaction. B) At 5 weeks of the primary tumor cell culture, the cells exhibited typical storiform pattern of MFH. C) The established cell strain revealed immunoreactivity for MEP-1 and Anti-hPH(beta), but negative for TRPM-3. The cloned tumor cells showed morphologic characteristics of undifferentiated fibroblastic cell. Latex particle (0.80 micrometer size) phagocytosis was negative in the cloned cell strain. The results of the current study support the concept that principal component cells of MFH is of fibroblastic cell origin.

Case Reports

Small Cell Osteosarcoma Similar to Ewing's Sarcoma in Histologic Findings and MIC2 Expression: A case report.: Yoon Mee Kim, Suk Woo Yang, Mee Yon Cho, Soon Won Hong, Byung Ho Choi; Korean J Pathol. 1999;33(3):204-209.

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Abstract PDF: Small cell osteosarcoma is a rare form of osteosarcoma and the histological differential diagnosis from other small round cell tumors (SRCTs) is difficult. The immunohistochemical stain for MIC2 has been considered an useful diagnostic marker for Ewing's sarcoma and primitive neuroectodermal tumors but recently, other SRCTs such as malignant lymphoma and embryonal rhabdomyosarcoma also showed positive reaction. Therefore, the usefulness of MIC2 must still be proven. We experienced a case of small cell osteosarcoma of the mandible in a 25-year-old man. Histologically, the tumor consisted of small round cells that resembled those of Ewing's sarcoma. Immunohistochemically, the tumor cells expressed diffuse strong positive reaction for MIC2 gene products. However, the scanty foci of lacy osteoid material between the tumor cells seemed to be diagnostic of osteosarcoma. The histologic and immunohistochemical findings of this case suggest close relationship between small cell osteosarcoma and Ewing's sarcoma.

Atypical Carcinoid of the Larynx: A report of two cases.: Yong Hee Lee, Young Nyun Park, Dong Hwan Shin, Yoo Bok Lee; Korean J Pathol. 1995;29(2):232-237.

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Abstract PDF: Atypical laryngeal carcinoid is a rare tumor with a poor prognosis, mostly occurring in the supraglottic larynx. It is a subtype of neuroendocrine carcinoma which should be separated from typical carcinoid and small cell carcinoma. The histogenesis and standardized classification of laryngeal neuroendocrine carcinoma have not been clearly defined. In this report, we present two cases of atypical laryngeal carcinoid, one occurring in a 67 year old male and the other in a 54 year old female. Indirect laryngoscopy revealed a polypoid supraglottic mass, approximately 3 cm in diameter. Microscopically, each case showed a moderate degree of pleomorphism, tumor necrosis and frequent mitoses. The immunohistochemistry revealed a strong positive reaction for chromogranin, neuron specific enolase and cytokeratin. Each patient had distant metastasis, noted within 4 months after resection (liver and stomach), and died postoperatively at 5 and 20 months, respectively. A brief review of the literature concerning the biological behavior, histogenesis and pathology of atypical laryngeal carcinoid was performed.

Microcystic Adnexal Carcinoma: Report of two cases.: Kyoung Mee Kim, Mi Kyung Jee, Ki Wha Yang, Seok Jin Kang; Korean J Pathol. 1994;28(3):302-306.

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Abstract: The clincopathologic features of microcystic adnexal carcinoma are presented. Microcystic adnexal carcinoma is a recently described, very rare neoplasm characterized by a locally aggressive growth pattern, and as far as we know, only two reports on the microcystic adnexal carcinoma have been published in the Korean literature. Recently we experienced two cases of microcystic adnexal carcimoma occurred in a 32-year-old male and 27-year-old female patient. They had 2.5 x 2.0 x 2.0 cm and 1.2 x 0.9 x 0.9 cm sized, slowly growing mass in the glabella and below the lower lip, respectively. The immunohistochemical staining for CEA antigen stains the glandular structures but not pilar structures. So we thinked that this tumor would be originated from primitive adnexal cells differentiating into both pilar and eccrine structures.

Bednar Tumor: A case report with discusion of histogenesis.: Mee Soo Chang, Kye Yong Song; Korean J Pathol. 1993;27(6):659-662.

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Abstract PDF: The authors examined a case of Bednar tumor(pigmented dermatofibrosarcoma protuberans). A 35-year-old woman presented with protruding black back mass 3x2.5 cm in surface dimension and 1 cm in heigh, which has grown slowly for 30 years. Microscopically the lesion is characterized by spindle cells arranged in storiform pattern and admixed with melanin containing dendritic cells. Ultrastructural study revealed three cell populations: (1) cells resembling fibroblasts, (2) cells resembling perineural cells, and (3) melanocytes. The immunohistochemical study using S-100 protein alpha-1 antitrypsin, antichymotrypsin and EMA revealed negative reaction in spindle fibroblastic tumor cells. The histogenesis of this neoplasm remains controversial; neuroectoderm, perineural cell, fibroblast and histiocyte. Through the ultrastructural study and immunohistochemical study, the authors suggested that Bedner tumor arises form the neuroectoderm with bidirectional to perineural and fibroblastic differentiation.

Clear Cell Sarcoma of the Kidney: A case report.: Soon Ae Oak, Bang Hur, Man Ha Huh; Korean J Pathol. 1993;27(1):81-84.

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Abstract PDF: Clear Cell Sarcoma of the Kidney(CCSK) is a rare malignant childhood tumor which is distinguished from Wilms tumor by its pathologic features, clinical presentation and frequent occurrence of metastasis to bone. We report a case of CCSK from a 2 year-old girl in the right kidney, followed by metastasis to thoracic vertebrae and left temporal lobe. Histogenesis of this tumor is controversial, although some studies suggest primitive mesenchymal origin. This case was studied with the aids of immunohistochemistry and electron microscopy in an effort to verify the histogenesis of the tumor. Vimentin was reactive in tumor cell, but cytokeratin, GFAP, S-100 protein and desmin were not stained, which confirmed the previous reports by others. Ultrastructural observation of the tumor cells showed neither features of epithelial cell nor differentiated mesenchymal cells.

Trichoadenoma: Report of a case.: Youn Soo Lee, Mi Kyung Lee, Seok Jin Gang, Byoung Kee Kim, Sun Moo Kim; Korean J Pathol. 1993;27(1):75-77.

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Abstract PDF: The clinical and pathological features of trichoadenoma are presented. Trichoadenoma is very rare, and as far as we know, no report on the trichoadenoma has been published in korea literature. We experienced a case of trichoadenoma occured in a 29 year-old male, who had a 0.9x0.7x0.4cm sized and slowly growing mass in the right buttock. The histopathological findings and histogenesis of trichoadenoma were discussed and a brief review of the literature was made.

Sebaceous Epithelioma: A report of 2 cases.: Youn Soo Lee, Mi Kyoung Jee, Seok Jin Gang, Byoung Kee Kim, Sun Moo Kim; Korean J Pathol. 1993;27(1):58-63.

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Abstract PDF: Sebaceous epithelioma is a relatively rare tumor, mostly occuring in the face or scalp. The histogenesis and clinical and pathological features of sebaceous epithelioma have not been clearly defined, and a few other diagnostic terms have been used so far instead of sebaceous epithelioma. Two cases of sebacous epitheliomas were presented. No recurrence or metastasis was observed in our cases, so sebaceous epithelioma is considered to be a benign tumor. A brief review of the literature, concerned about the biological behavior, histogenesis and pathological findings of the sebaceous epithelioma, was made.

Intracerebral Metastasis of Alveolar Soft Part Sarcoma: A case report and study on its histogenesis.: Young Chae Chu, Joon Mee Kim, Young Bae Kim, Tae Sook Hwang; Korean J Pathol. 1992;26(5):510-516.

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Abstract PDF: We describe a case metastatic alveolar soft part sarcoma of the brain in a 20-year old man. Alveolar soft part sarcoma is slowly growing tumor which almost shows conspicuous vascular invasion and have a high incidence of blood-borne metastasis. The principal metastatic sites are the lungs, followed by the skeleton and brain. Cerebral metastases may be the first manifestation of the disease and are more common with alveolar soft part sarcoma than with any other type of soft tissue sarcoma. The light-and electron-microscopic and immunohistochemical findings are described. Periodic acid-Schiff-positive, diastase resistant, intracytoplasmic crystals, pathognomonic for alveolar soft part sarcoma, are present. The cells expressed immunoreactivity for vimentin, desmin, neuron-specific enolase, S-100 protein and renin. The results of our own immunohistochemical examinations is suggestive of myoendocrine origin.

Pulmonary Adenocarcinoma of Fetal Type: Report of a case.: Soon Bong Chung, Il Seon Lee, Hee Kyung Chang, Bang Hur, Man Ha Huh; Korean J Pathol. 1992;26(2):186-190.

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Abstract PDF: Adenocarcionma of fetal type is in lung is a newly recognized malignant tumor sharing morphologic features with the epithelial component of the pulmonary blastoma devoid of sarcomatous component. We present a case of adenocarcinoma of fetal type in a 28-year-old female, consisting of numerous branching tubules or glands and morula-like epithelial complexes. Histologically, the tubules and glands were composed of glycogne-rich nonciliated epithelial cells showing in part argyrophilia. Some of tubular and morula-like epithelial cells revealed immunoreactivity for neuron-specific enolase. We report this case with a review of literatures with special references on the histogenisis. This report is the pathologically confirmed second case of the pulmonary adenocarcinoma of fetal type in Korea, following the report of Cho and Lee, 1990.

Original Articles

Immunohistochemical and Ultrastructural Cellular Differentiation in Papillary and Solid Epithelial Neoplasm of the Pancreas.: Jae Hyuck Lee, Min Cheol Lee, Chang Soo Park, Kyu Hyuk Cho; Korean J Pathol. 1992;26(1):40-52.

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Abstract PDF: Papillary and solid epithelial neoplasm of the pancreas from five patients were studied using immunohistochemistry and electron microscopy to define the cellular origin of this type of tumor. The tumors ranged in diameter form 5.5 to 15 cm Grossly, these were well circumscribed by a firm, gray-white, fibrous capsule and their cut-surface showed mainly area containing mucinous substance with necrotic and hemorrhagic material, with some solid portion. Microscopically, there was a solid and papillary pattern, with uniform cells typically having round to ovoid nuclei containing indistinct nucleoli and eosinophilic, granular cytoplasm. Within the cytoplasm of the tumor cells, numerous PAS-positive granules were found. Immunostaining was positive for neuron-specific enolase(three of five cases), alpha1-antitrypsin and alpha1-antichymotrypsin(three of five cases) in the solid and papillary portion of the tumor. But no polypeptide hormone immunoreactive cells were present in all cases except for gastrin which showed focally weak positivity in the papillary area. Ultrastructurally, the papillary and solid epithelial neopasm of the pancreas showed evidence of acinar cell differentiation, because in the cell of one observed some zymogen-like granules and presence of annulate lamellae. But also, abundant typical neurosecretory granules were detected in the tumor cells ultrastructurally. Both facts suggested acinar and islet cell differentiation of the tumor. From the these findings, it concluded that papillary and solid epithelial neoplasm of the pancreas may be originated from a primordial cell which will be able to render both endocrine and exocine component.

Histologic Variations of Intramural Heterotopic Pancreas in Gastrointestinal Tract Analysis of 15 Cases.: Seung Sook Lee, Yong Il Kim, Woo Ho Kim, Eun Sil Yu; Korean J Pathol. 1991;25(6):520-527.

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Abstract PDF: We reviewed a total of 15 cases of heterotopic pancreatic tissue within the gastrointestinal wall(intramural type), and compared with 3 extramural ones. Intramural heterotopic pancreatic lesions were located in the antrum(33%), pylorus(20%), and body of stomach(7%), and the remainders in the duodenum(40%). Only two cases presented with chinical symptoms by their existence. Two of them were situated within the submucosa, 3 in the muscularis, 6 in submucosa-muscularis, 2 in the muscularis-subserosa, and 1 in the susbmucosa-subserosa. Intramural type was featured with their structural heterogeneity compared to the extramural ones; 10 cases showed participation of gastrointestinal mucosal elements, and some accompanied tissue elements that were indistinguishable from submucosal epithelial heterotopia or microduplication cyst of the stomach. Langerhans islets were found in 67%, and one developed islet cell tumor. The above results suggest that the initially engrafted heterotopic pancreatic tissue becomes modified and presents with heterogeneity of endodermal and mesodermal tissue-derived components by its intramural growth during the gastrointestinal organogenesis; failure of opening of its drainage system into the gastrointestinal lumen may result in the increase of intraductal pressure with subsequent atrophy of the acinar tissue and various metaplastic changes of ductal epithelium, aside from induction of smooth muscle coat around the heterotopic tissue.

Smooth Muscle Tumors of the Stomach : A clinicopathologic analysis of 46 cases.: Mee Soo Chagn, Yong Il Kim, Woo Ho Kim; Korean J Pathol. 1991;25(5):418-426.

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Abstract: This study was undertaken to characterize the clinicopathologic features of smooth muscle tumors of the stomach with additional regard to recent controversy over the gastrointestinal smooth mscle tumors. A total of 46 consecutive cases(47 tumors) of surgically resected or excised gastric smooth muscle tumors, were assessed for review. The criteria for malignancy applied in this study were one of the followings; (1) 5 or more mitoses/10 HPF or (2) 1-4 mitoses/10 HPF with tumor cell necrosis and 5 cm or greater in tumor size. The tumors were classified as ordinary leiomyoma in 24 cases(25 tumors), epithelioid leiomyoma in 3, cellular leiomyoma in 6, ordinary leiomyosarcoma in 10, myxoid leiomyosarcoma in 2, and epithelioid leiomyosarcoma in 1. Of the 46 cases, 13 cases(28%) were categorized as malignant smooth muscle tumor. But immunohistochemical study for S-100 protein, desmin and vimentin(5 cases), and ultrastructural study(2 cases) support that myogenic or neurogenic differentiation is evident simultaneously within the same tumor, regardless of malignancy, and that even the differentiated tumor cells seem to express such direction toward immature smooth muscle cell or nerve cell.

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