Journal of Pathology and Translational Medicine

Brief Case Report

Goblet Cell Carcinoid of the Rectum in a Patient with Neurofibromatosis Type 1: Youngjin Kang, Jung-Woo Choi, Younghye Kim, Hwa Eun Oh, Ju-Han Lee, Young-Sik Kim; J Pathol Transl Med. 2016;50(6):482-485. Published online May 29, 2016; DOI: https://doi.org/10.4132/jptm.2016.02.27

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Case Study

Human Cutaneous Protothecosis: Report of a Case and Literature Review: Jae Yeon Seok, Yoonho Lee, Hyukmin Lee, Sang Yeop Yi, Hwa Eun Oh, Ji-Sun Song; Korean J Pathol. 2013;47(6):575-578. Published online December 24, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.6.575

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Abstract PDF

The Prototheca species is achlorophyllic algae and rarely causes human infection. Human protothecosis presents clinically as a cutaneous infection, olecranon bursitis, and disseminated systemic disease. We report a case of human cutaneous protothecosis involving the left wrist. A 68-year-old man presented with an ill-defined erythematous lesion with crust at the dorsal aspect of his left wrist. A punch biopsy was performed to reveal the histologic features of granulomatous inflammation with necrosis at the upper dermis, containing Prototheca organisms, of which, the characteristic features were highlighted by special staining. Through a molecular study, the Prototheca zopfii species was identified.

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Successful Treatment of Cutaneous Protothecosis Due to Prototheca wickerhamii with Terbinafine
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Disseminated Protothecosis Due to Prototheca zopfii and Literature Review
Feifan Chen, Mario Saab-Chalhoub, Joy Tao, Amanda T. Harrington, Fritzie S. Albarillo, Andrew S. Crone, Nina M. Clark, Jodi J. Speiser
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The oldest patient infected with cutaneous protothecosis
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Protothecosis algaemia in a patient presenting with septic arthritis: A rare case of Prototheca zopfii isolated from Malaysia
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Protothecal bursitis after simultaneous kidney/liver transplantation: a case report and review
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Original Article

Telomerase Activity in Urethane-Induced Mouse Lung Tumorigenesis.: Ji Sun Song, Soon Hee Jung, Sang Yeop Yi, Hwa Eun Oh, Mee Yon Cho, Kwang Hwa Park; Korean J Pathol. 2011;45(3):261-270.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.3.261

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Abstract PDF

BACKGROUND
Telomerase activity in precancerous conditions of lung adenocarcinomas has not been well studied. This study is designed to investigate the role of telomerase in premalignant lesions of urethane-induced mouse lung adenocarcinoma.
METHODS
We harvested A/J mouse lung tissues at 3, 6, 9, 12, 28, 41, and 48 weeks after intraperitoneal urethane treatment, and classified each lesion in terms of histologic findings. We examined telomerase activity using a modified version of the telomeric repeat amplification protocol assay using both gel-based and enzyme linked immunosorbent assay methods. An immunohistochemical analysis of proliferating cell nuclear antigen (PCNA) was performed.
RESULTS
In urethane-induced mouse lung tissues, it was sequentially developed from hyperplasia, adenoma, and eventually to adenocarcinoma. Telomerase activity began to show a positive level in tissues with no histologically visible nodule after urethane administration. It revealed a statistically significant increase in hyperplasia compared to the "control" lung tissue (p<0.05), which was proportionally elevated relative to adenoma and adenocarcinoma. There was a direct correlation between telomerase activity and the PCNA labeling index (p<0.05).
CONCLUSIONS
The elevation of telomerase activity in normal-appearing lung lesions is thought to be a possible marker of early detection of pulmonary adenocarcinoma.

Citations

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Non-invasive quantification of cell-free DNA mutations in plasma during lung tumor progression in mice
Soo-Jin Kim, Eunhee Kim, Kyung-Taek Rim
Cancer Biomarkers.2017; 20(4): 477. CrossRef

Case Report

Inflammatory Pseudotumor of the Kidney.: Hwa Eun Oh, Jeong Seok Moon, Sung Jin Cho, Nam Hee Won; Korean J Pathol. 1997;31(6):592-594.

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Abstract PDF: Inflammatory pseudotumor, originally described in the lung, is a relatively rare tumor-like lesion that occurs in various organs and tissues. It is usually well demarcated from the surrounding tissue, however it can be unfortunately resected as a malignant tumor. A few inflammtory pseudotumor in the kidney have been reported in English literature, but there have been no reports in Korea. We report a case with inflammatory pseudotumor of the kidney. A 48 year old woman had an intermittent flank pain on the right side. An ultrasonographic study suggested a renal cell carcinoma and a nephrectomy was done. Grossly, there were two separate masses with a well demarcated yellowish appearance, measuring 2.3 cm and 1.3 cm in diameter, respectively. Histologically, they were composed of smooth muscle actin positive spindle cells and a large number of foamy histiocytes, lymphocytes, and plasma cells in the fibrotic backgound.

Original Article

Correlation of the Intestinal Metaplasia Subtypes and Gastric Carcinoma.: Hwa Eun Oh, Mee Ja Park, Jong Sang Choi; Korean J Pathol. 1997;31(12):1272-1281.

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Abstract PDF: Helicobacter pylori, loss of basement membrane, atrophy, type III intestinal metaplasia, adenomatous polyposis coli (APC) gene mutations and altered p53 function were believed as a factor to develop the gastric adenocarcinomas. To investigate the incidence and prevalence of Helicobacter pylori, intestinal metaplasia and atrophy, 120 gastrectomy specimens collected from patients with gastric adenocarcinoma (100 cases) and non-neoplastic conditions (20 cases) were studied. Intestinal metaplasia can be classified as type I (complete), type II (incomplete, sulfomucin-negative) and type III (incomplete, sulfomucin-positive) by Filipe and Jass. The incidence of intestinal metaplasia of gastric adenocarcinoma was 96% compared with the incidence of 75% in non-neoplastic conditions. The type I and type II were more common than type III and were present in both non-neoplastic conditions (75%) and adenocarcinoma (74%). In contrast, type III intestinal metaplasia was seen in only 20% of intestinal metaplasia-positive cases, all of which (22 of 22) were from patients with adenocarcinoma. The high specificity of type III intestinal metaplasia might be acceptable for screening purposes, but its sensitivity of 22% for gastric adenocarcinoma is low. Helicobacter pylori were detected in 96% of adenocarcinoma cases and 100% of non-neoplastic cases. Atrophy was detected in 50% of non-neoplastic cases and in 57% of adenocarcinoma cases. The data thus confirms a significant relation between incomplete sulfomucin-secreting intestinal metaplasia (type III) and gastric carcinoma, especially intestinal type (p<0.01). Thus, the type III intestinal metaplasia should be considered a risk factor and its presence in a biopsy specimen should prompt close surveillance.

Case Report

Leiomyosarcoma of the Pancreas: A case report.: Bong Kyung Shin, Jung Suk Moon, Hwa Eun Oh, Nam Hee Won, Jong Sang Choi; Korean J Pathol. 1999;33(9):733-736.

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Abstract PDF: Most of the malignant tumors of the pancreas are adenocarcinomas arising from the ductal epithelium. Primary leiomyosarcoma of the pancreas, even though it is the most common sarcoma of the pancreas, is very rare. We present a case of leiomyosarcoma of the pancreas, probably primary, with metastases to the stomach, lymph nodes, and abdominal wall. A 52-year-old woman visited the hospital with vague right upper abdominal pain and weigh loss of 6 kg for 2 months. The radiological and endoscopic examination revealed that she had a large heterogeneous mass, 11 cm in size, in the pancreatic body and tail, a 4 cm-sized mass in the paraaortic area, and a 3 cm-sized polypoid mass in the stomach. Histologically, they were all similar to one another and composed of markedly pleomorphic cells. Immunohistochemical and electron microscopic studies showed definite smooth muscle differentiation of the tumor cells. Two months later, the patient underwent an excision of a new 3 cm mass in the right lower abdominal wall, showing features of well differentiated leiomyosarcoma.

Original Articles

Expression of p53 and Matrix Metalloproteinase-2 Proteins in Colorectal Adenocarcinoma.: Seong Jin Cho, Hwa Eun Oh, Yang Seok Chae; Korean J Pathol. 2000;34(7):494-500.

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Abstract PDF: The p53 gene is believed to play an important role through the mutation and overexpression in the progression of various human malignant tumors. The type IV collagenase (matrix metalloproteinase: MMP-2) initiates the degradation of the extracellular matrix, and consequently may play a role in the tumor invasion and metastasis. To investigate the correlation between clinicopathologic features of the colorectal adenocarcinomas and benign tumors and expression of p53 and MMP-2 proteins, we performed an immunohistochemical study on 40 colorectal adenocarcinomas, 20 adenomas and 20 hyperplastic polyps by using the antibodies to p53 and MMP-2 proteins. The positive expression rate of the p53 protein in adenocarcinomas was 62.5% and significantly higher than in benign tumors. The positive expression rate of the MMP-2 protein was 47.5% in adenocarcinomas, but there was no expression of MMP-2 protein in benign tumors. The difference in p53 and MMP-2 expression rates between malignant and non-malignant tumors was statistically significant. The positive expression rate of p53 protein in the non-metastatic and metastatic adenocarcinomas was 59.1 and 66.7%, respectively. The positive expression rate of MMP-2 protein in the non-metastatic and metastatic adencarcinomas was 45.5 and 50.0%, respectively. The correlation between several clinicopathologic features and expression of p53 and MMP-2 protein was not statistically significant, but the rate of positive MMP-2 immunoreactivity showed a statistically significant difference between Astler-Coller stage B1 C1 group and B2 C2 group of adenocarcinoma (p=0.0431). We concluded that the expression of p53 and MMP-2 protein contributes to the cancer development and MMP-2 may play a certain role in the invasiveness of the colorectal tumor. p53 and MMP-2 protein expression is not correlated with lymph node metastasis.

K-ras Gene Mutations and Expression of K-ras, p16, Cyclin D1 and p53 in Synchronous Lesions of The Colon Adenoma-Carcinoma Sequences.: Hwa Eun Oh, Seong Jin Cho, Nam Hee Won, Dale Lee, Insun Kim, Bom Woo Yeom; Korean J Pathol. 2001;35(4):291-298.

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Abstract PDF: BACKGROUND
The colorectal adenoma-carcinoma sequence represents a well-known para-digm for the sequential development of cancer driven by the accumulation of genomic defects. Although the colorectal adenoma-carcinoma sequence has been well investigated, the studies about tumors of different dignity co-existent in the same patient are rare. K-ras mutation is an early genetic change in colon cancer. The genes involved in the cell cycle such as cyclin D1, p16, and p53 are important in the tumorigenesis of the colon. The aims of this study were to determine K-ras gene mutation and expression of K-ras, p16, cyclin D1 and p53 in synchronous lesions of the colon adenoma-carcinoma sequences and their possible relationship with K-ras mutation.
METHODS
The materials included 45 colonic adenocarcinomas which were accompanied by adenoma (22 low grade and 26 high grade). By using polymerase chain reaction-single strand conformational polymorphism (PCR-SSCP), we detected K-ras mutation of codon 12. An aberrant K-ras, p16, cyclin D1 and p53 expressions were stained using an immunohistochemical method. RESULTS: K-ras mutation was 52.4% (11/21) of high grade adenomas. K-ras expression was 65.4% (17/26) of high grade adenomas. p16 and cyclin D1 expressions were 50% (11/22) and 90.9% (20/22) of low grade adenomas, respectively. p53 expression was 75.6% (34/45) of adenocarcinomas. There were statistical correlations among K-ras, p16 and cyclin D1.
CONCLUSIONS
These results indicate that the ras gene mutation is an early event and the overexpressions of p16, cyclin D1 and p53 are associated with K-ras mutation and expression in adenoma-carcinoma sequences.

Case Report

Cytologic Diagnosis of Malignant Fibrous Histiocytoma in Pleural Fluid: A Case Report.: Hwa Eun Oh, Yoo Hoon Kim, Seong Jin Cho, Young Sik Kim, In Sun Kim; Korean J Cytopathol. 1995;6(1):80-83.

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Abstract PDF: Malignant fibrous histiocytoma is the most common soft tissue sarcoma of late adult life, but it is rare in the pleura. We recently experienced a case of cytology of malignant fibrous histiocytoma in pleural fluid. The smear revealed histiocytic malignant cells, spindle malignant cells and inflammatory cells. The histiocytic cells showed abundant, pale cytoplasm and ovoid, irregular, eccentrically placed nuclei. The spindle cells showed elongated nuclei. Intercellular collagen was also present.

Original Article

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; Korean J Cytopathol. 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 Reports

Well Differentiated Papillary Mesothelioma of the Ovarian Surface: A Case Report.: Hwa Eun Oh, Ji Sun Song, Ki Young Ryu, Sun Lee; Korean J Pathol. 2006;40(4):311-313.

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Abstract PDF: Well differentiated papillary mesothelioma (WDPM) is an unusual variant of epithelial mesothelioma. Most WDPMs exhibit either benign or indolent behavior. Making the differential diagnosis between this rare tumor and serous papillary carcinoma can be problematic. We report here on a case of a 43-year-old woman with a WDPM of the surface. She presented to our hospital for a routine gynecologic evaluation, and she had no specific symptoms or a history of asbestos exposure. Gynecologic ultrasonography revealed a right ovarian mass that measured 6 x 3.8 x 3 cm in size. No ascites was detected. Right salpingo-oophorectomy was performed; grossly, the tumor was a yellowish firm, multinodular mass. Microscopically, the tumor consisted of numerous papillae that were lined by a single layer of uniform mesothelial cells. Nuclear pleomorphism and mitoses were not found. On immunohistochemical study, the tumor cells were positive for calretinin and cytokeratin, but they were negative for CEA. It is important to differentiate WDPM from serous papillary carcinoma or other malignant tumors to avoid treating them as malignant tumors.

Subcutaneous Bronchogenic Cyst of the Shoulder: A Case Report.: Ji Sun Song, Hwa Eun Oh, Sang Yeop Yi, Noh Hyuck Park, Ho Young Kim; Korean J Pathol. 2006;40(1):73-75.

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Abstract PDF: Bronchogenic cyst is an uncommon congenital anomaly that arises from maldevelopment of the primitive foregut, and is usually found in the lung and mediastinum. Cutaneous or subcutaneous bronchogenic cysts are rare, and occur especially in the shoulder region. We report here on a 40-year-old woman with a soft, nontender, cystic mass on the upper posterior aspect of the right acromioclavicular joint; this had been recognized about 20 years before. She underwent incision and drainage of the lesion at a local clinic about 1 year ago, but the wound was not healed. MRI showed an irregular-shaped dark signal intensity lesion that measured 2 x 1.5 cm in the subcutaneous fat layer. Microscopically, the cyst was lined by pseudostratified ciliated columnar epithelium that displayed squamous metaplasia. The cyst wall revealed frequent smooth muscle bundles, occasional seromucous glands and multifocal lymphocytic infiltration. This is the first reported case of subcutaneous bronchogenic cyst of the shoulder in a Korean adult.

Toxoplasmic Lymphadenitis with Toxoplasma Bradyzoites: A Case Report.: Hwa Eun Oh, Insun Kim; Korean J Pathol. 2004;38(5):330-332.

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Abstract PDF: Toxoplasmic lymphadenitis is the most frequently observed clinical form of acquired toxoplasmosis. It is diagnosed by observing the characteristic histopathology, performing serologic tests and demonstrating the organisms. However, detection of the organisms in lymph node section is rarely accomplished. We demonstrate a case of a toxoplasmic lymphadenitis of a 40-year-old man with bradyzoites. The histopathologic findings of the lymph nodes showed reactive follicular hyperplasia associated with the presence of irregular clusters of epithelioid histiocytes, usually located in the cortical and paracortical zones, and monocytoid B cell proliferation. We demonstrated the bradyzoites of Toxoplasma gondii with periodic acid-Schiff (PAS)-stain, and serologic testing showed positive Ig-G and Ig-M toxoplasma antibodies.

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