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The Predictive Value of Pathologic Features in Pituitary Adenoma and Correlation with Pituitary Adenoma Recurrence
Jee Soon Kim, Youn Soo Lee, Min Jung Jung, Yong Kil Hong
J Pathol Transl Med. 2016;50(6):419-425.   Published online October 6, 2016
DOI: https://doi.org/10.4132/jptm.2016.06.30
  • 7,812 View
  • 234 Download
  • 17 Web of Science
  • 17 Crossref
AbstractAbstract PDF
Background
The 2004 World Health Organization classification introduced atypical pituitary adenoma (aPA), which was equivocally defined as invasion with increased mitotic activity that had a Ki-67 labeling index (LI) greater than 3%, and extensive p53 immunoreactivity. However, aPAs that exhibit all of these features are rare and the predictive value for recurrence in pituitary adenomas (PAs) remains uncertain. Thus, we sought to characterize pathological features of PAs that correlated with recurrence.
Methods
One hundred and sixty-seven cases of surgically resected PA or aPA were retrieved from 2011 to 2013 in Seoul St. Mary’s Hospital. Among them, 28 cases were confirmed to be recurrent, based on pathologic or radiologic examination. The pathologic characteristics including mitosis, invasion, Ki-67 LI and p53 immunoreactivity were analyzed in relation to recurrence.
Results
Analysis of the pathologic features indicated that only Ki-67 LI over 3% was significantly associated with tumor recurrence (p = .02). The cases with at least one pathologic feature showed significantly higher recurrence rates (p < .01). Analysis indicated that cases with two pathologic features, Ki-67 LI over 3% and extensive p53 immunoreactivity 20% or more, were significantly associated with tumor recurrence (p < .01).
Conclusions
Based on these results, PA tumor recurrence can be predicted by using mitosis, invasion, Ki-67 LI (3%), or extensive p53 immunoreactivity (≥ 20%). Assessment of these features is recommended for PA diagnosis for more accurate prediction of recurrence.

Citations

Citations to this article as recorded by  
  • The Value of ER∝ in the Prognosis of GH- and PRL-Secreting PitNETs: Clinicopathological Correlations
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    European Journal of Endocrinology.2018; 178(3): 237.     CrossRef
  • Letter to the Editor. Atypical pituitary adenoma
    Lauren E. Rotman, T. Brooks Vaughan, James R. Hackney, Kristen O. Riley
    Journal of Neurosurgery.2018; 129(6): 1657.     CrossRef
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    Endocrine-Related Cancer.2017; 24(6): R239.     CrossRef
Differential Immunohistochemical Profiles for Distinguishing Prostate Carcinoma and Urothelial Carcinoma
Woo Jin Oh, Arthur Minwoo Chung, Jee Soon Kim, Ji Heun Han, Sung Hoo Hong, Ji Yeol Lee, Yeong Jin Choi
J Pathol Transl Med. 2016;50(5):345-354.   Published online August 7, 2016
DOI: https://doi.org/10.4132/jptm.2016.06.14
  • 11,481 View
  • 328 Download
  • 28 Web of Science
  • 31 Crossref
AbstractAbstract PDF
Background
The pathologic distinction between high-grade prostate adenocarcinoma (PAC) involving the urinary bladder and high-grade urothelial carcinoma (UC) infiltrating the prostate can be difficult. However, making this distinction is clinically important because of the different treatment modalities for these two entities.
Methods
A total of 249 patient cases (PAC, 111 cases; UC, 138 cases) collected between June 1995 and July 2009 at Seoul St. Mary’s Hospital were studied. An immunohistochemical evaluation of prostatic markers (prostate-specific antigen [PSA], prostate-specific membrane antigen [PSMA], prostate acid phosphatase [PAP], P501s, NKX3.1, and α-methylacyl coenzyme A racemase [AMACR]) and urothelial markers (CK34βE12, p63, thrombomodulin, S100P, and GATA binding protein 3 [GATA3]) was performed using tissue microarrays from each tumor.
Results
The sensitivities of prostatic markers in PAC were 100% for PSA, 83.8% for PSMA, 91.9% for PAP, 93.7% for P501s, 88.3% for NKX 3.1, and 66.7% for AMACR. However, the urothelial markers CK34βE12, p63, thrombomodulin, S100P, and GATA3 were also positive in 1.8%, 0%, 0%, 3.6%, and 0% of PAC, respectively. The sensitivities of urothelial markers in UC were 75.4% for CK34βE12, 73.9% for p63, 45.7% for thrombomodulin, 22.5% for S100P, and 84.8% for GATA3. Conversely, the prostatic markers PSA, PSMA, PAP, P501s, NKX3.1, and AMACR were also positive in 9.4%, 0.7%, 18.8%, 0.7%, 0%, and 8.7% of UCs, respectively.
Conclusions
Prostatic and urothelial markers, including PSA, NKX3.1, p63, thrombomodulin, and GATA3 are very useful for differentiating PAC from UC. The optimal combination of prostatic and urothelial markers could improve the ability to differentiate PAC from UC pathologically.

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Brief Case Report
Primary Neurilemmoma of the Thyroid Gland Clinically Mimicking Malignant Thyroid Nodule
Young Sub Lee, Jee Soon Kim, Arthur Minwoo Chung, Woo Chan Park, Tae-Jung Kim
J Pathol Transl Med. 2016;50(2):168-171.   Published online October 26, 2015
DOI: https://doi.org/10.4132/jptm.2015.08.26
  • 7,992 View
  • 71 Download
  • 1 Web of Science
  • 4 Crossref
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Citations

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