Journal of Pathology and Translational Medicine

Original Article

Prognostic Implication of Semi-quantitative Immunohistochemical Assessment of CD20 Expression in Diffuse Large B-Cell Lymphoma: Chang Hwan Choi, Young Hoon Park, Joo Han Lim, Suk Jin Choi, Lucia Kim, In Suh Park, Jee Young Han, Joon Mee Kim, Young Chae Chu; J Pathol Transl Med. 2016;50(2):96-103. Published online February 15, 2016; DOI: https://doi.org/10.4132/jptm.2016.01.12

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Background
Immunohistochemical demonstration of CD20 in diffuse large B-cell lymphoma (DLBCL) is prerequisite not only for the diagnosis but also for assigning patients to rituximab-containing chemotherapy. However, little is known about the impact of abundance of CD20 expression assessed by immunohistochemistry on the clinical outcome of DLBCL. We performed a semi-quantitative immunohistochemical analysis of CD20 expression in DLBCL to examine the prognostic implication of the level of CD20 expression. Methods: Pre-treatment diagnostic tissue samples from 48 DLBCL patients who were treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) regimen were represented in a tissue microarray and immunostained for CD20. The relative abundance of CD20 expression was semi-quantitatively scored using a web-based ImmunoMembrane plug-in. Receiver operating characteristic curve analysis was used to determine a prognostically relevant cut-off score in order to dichotomize the patients into CD20-high versus CD20-low groups. Results: The levels of CD20 expression were heterogeneous among the patients, with a wide and linear distribution of scores. Patients in CD20-low group showed significantly poor clinical outcome. Conclusions: The levels of CD20 expression in DLBCL are heterogeneous among the patients with DLBCL. A subgroup of the patients with CD20 expression levels below the cut-off score showed poor clinical outcome.

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Induced CD20 Expression on B-Cell Malignant Cells Heightened the Cytotoxic Activity of Chimeric Antigen Receptor Engineered T Cells
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Brief Case Report

Myoepithelial Carcinoma of Soft Tissue: A Case Report and Review of the Literature: Chang Hwan Choi, Young Chae Chu, Lucia Kim, Suk Jin Choi, In Suh Park, Jee Young Han, Joon Mee Kim; Korean J Pathol. 2014;48(6):413-417. Published online December 31, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.6.413

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Original Articles

Preparation of Compact Agarose Cell Blocks from the Residues of Liquid-Based Cytology Samples: Suk Jin Choi, Yeon Il Choi, Lucia Kim, In Suh Park, Jee Young Han, Joon Mee Kim, Young Chae Chu; Korean J Pathol. 2014;48(5):351-360. Published online October 27, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.5.351

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Abstract PDF

Background: Inevitable loss of diagnostic material should be minimized during cell block preparation. We introduce a modified agarose cell block technique that enables the synthesis of compact cell blocks by using the entirety of a cell pellet without the loss of diagnostic material during cell block preparations. The feasibility of this technique is illustrated by high-throughput immunocytochemistry using high-density cell block microarray (CMA). Methods: The cell pellets of Sure- Path residues were pre-embedded in ultra-low gelling temperature agarose gel and re-embedded in standard agarose gel. They were fixed, processed, and embedded in paraffin using the same method as tissue sample processing. The resulting agarose cell blocks were trimmed and represented on a CMA for high-throughput analysis using immunocytochemical staining. Results: The SurePath residues were effectively and entirely incorporated into compact agarose cell buttons and embedded in paraffin. Sections of the agarose cell blocks revealed cellularities that correlated well with corresponding SurePath smears and had immunocytochemical features that were sufficient for diagnosis of difficult cases. Conclusions: This agarose-based compact cell block technique enables preparation of high-quality cell blocks by using up the residual SurePath samples without loss of diagnostic material during cell block preparation.

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Elif Kuzucular, Ferhat Ozden, Bahar Muezzinoglu
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C.‐H. Wen, C.‐H. Lin, P.‐L. Ko, Y.‐F. Kuo, Y.‐J. Chen, C.‐Y. Chai
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The Clinicopathological Significance of Epithelial Mesenchymal Transition Associated Protein Expression in Head and Neck Squamous Cell Carcinoma: Kyu Ho Kim, Lucia Kim, Suk Jin Choi, Jee Young Han, Joon Mee Kim, Young Chae Chu, Young-Mo Kim, In Suh Park, Joo Han Lim; Korean J Pathol. 2014;48(4):263-269. Published online August 26, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.4.263

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Abstract PDF

Background

Epithelial mesenchymal transition (EMT) has an important role in invasion and metastasis of tumor cells. The purpose of this study was to evaluate the roles of EMT-associated proteins on progression and metastasis as a prognostic/predictive factor in curatively-resected (R0) head and neck squamous cell carcinoma (HNSCC).

Methods

A total of 118 patients who received curative surgery for HNSCC at Inha University Hospital between January 1996 and December 2011 were included. We used protein immunohistochemistry to evaluate the expression of E-cadherin, vimentin, and EZH2 on tissue microarrays. Also, we reviewed all medical records and analyzed the relationship between the expression of EMT-associated proteins and prognosis.

Results

The E-cadherin-negative group showed more moderate/poor differentiation of cancer cell type than the higher E-cadherin-expressing group (p=.016) and high EZH2 expression was significantly correlated with nodal metastasis (p=.012). Our results demonstrate a significant association between high expression of EZH2 and vimentin and presence of distant progression (p=.026). However, expression of E-cadherin, vimentin, and EZH2 was not significantly associated with overall survival.

Conclusions

These findings suggest that an EMT-associated protein expression profile is correlated with aggressiveness of disease and prognosis, and could be a useful marker for determination of additional treatment in curatively-resected HNSCC patients.

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Cancer Cell International.2018;[Epub] CrossRef
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In-house Manual Construction of High-Density and High-Quality Tissue Microarrays by Using Homemade Recipient Agarose-Paraffin Blocks: Kyu Ho Kim, Suk Jin Choi, Yeon Il Choi, Lucia Kim, In Suh Park, Jee Young Han, Joon Mee Kim, Young Chae Chu; Korean J Pathol. 2013;47(3):238-244. Published online June 25, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.3.238

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Abstract PDF

Background

Self-made tissue punches can be effectively used to punch holes in blank recipient paraffin blocks and extract tissue cores from the donor paraffin blocks for the low-cost construction of tissue microarrays (TMAs). However, variable degrees of section distortion and loss of the tissue cores can occurs during cutting of the TMAs, posing technical problems for in-house manual construction of high-density TMAs. We aimed to update the method for in-house manual TMA construction to improve the quality of high-density TMAs.

Methods

Blocks of agarose gel were subjected to the standard tissue processing and embedding procedure to prepare recipient agarose-paraffin blocks. The self-made tissue punches and recipient agarose-paraffin blocks were used to construct TMAs, which were completely melted and re-embedded in paraffin to make finished TMA blocks.

Results

The donor tissue cores were completely integrated into the surrounding paraffin of the recipient blocks. This method enabled us to construct high-density TMAs with significantly less section distortion or loss of tissue cores during microtomy.

Conclusions

Simple and inexpensive construction of high-density and high-quality TMAs can be warranted by using paraffinized agarose gels as recipient blocks.

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Prognostic Implication of Semi-quantitative Immunohistochemical Assessment of CD20 Expression in Diffuse Large B-Cell Lymphoma
Chang Hwan Choi, Young Hoon Park, Joo Han Lim, Suk Jin Choi, Lucia Kim, In Suh Park, Jee Young Han, Joon Mee Kim, Young Chae Chu
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Case Study

Peripheral Primitive Neuroectodermal Tumor with Osseous Component of the Small Bowel Mesentery: A Case Study: Joon Mee Kim, Young Chae Chu, Chang Hwan Choi, Lucia Kim, Suk Jin Choi, In Suh Park, Jee Young Han, Kyung Rae Kim, Yoon-La Choi, Taeeun Kim; Korean J Pathol. 2013;47(1):77-81. Published online February 25, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.1.77

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Abstract PDF

A case of peripheral primitive neuroectodermal tumor of the small bowel mesentery with osseous component is reported. A 23-year-old man was admitted to our hospital because of acute severe abdominal pain. Abdominal computed tomography revealed a large solid and cystic, oval shaped mass, measuring 11.0×6.0 cm in the pelvic cavity. Histologically the resected lesion consisted of sheets of undifferentiated small round cells forming Homer-Wright rosettes and perivascular pseudorosettes, and showed areas of osteoid and bone formation. Immunohistochemical studies revealed that tumor cells expressed positivity against CD99 (MIC2), CD57, neuron-specific enolase, and vimentin. Fluorescence in situ hybridization study revealed Ewing sarcoma breakpoint region 1 (EWSR1) gene rearrangement on chromosome 22q12. To the authors' knowledge this is the first documentation of a peripheral neuroectodermal tumor with osteoid and bone formation of the small bowel mesentery.

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Original Article

Construction of High-Density Tissue Microarrays at Low Cost by Using Self-Made Manual Microarray Kits and Recipient Paraffin Blocks: Chang Hwan Choi, Kyu Ho Kim, Ju Young Song, Suk Jin Choi, Lucia Kim, In Suh Park, Jee Young Han, Joon Mee Kim, Young Chae Chu; Korean J Pathol. 2012;46(6):562-568. Published online December 26, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.6.562

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Abstract PDF

Background

Advances of tissue microarray (TMA) technology have enabled simultaneous in situ analysis of biomarker expression in a large number of archived pathology specimens. However, the relatively high cost of TMA construction may hamper many researchers from using this essential tool of modern pathology research. We discuss methods for making TMA kits and recipient blocks for manual construction of high-density TMAs at low cost.

Methods

Ordinary cannula piercing needles, hypodermic needles, bone marrow biopsy needles, metallic ink cartridges of ballpoint pens, and disposable skin biopsy punches were used to construct self-made manual TMA kits. The recipient blocks were manufactured by boring holes in the conventional bare paraffin blocks. A mini electric hand drill and a microcompound table assembled on a drill stand were used to maximize the capacity of the recipient blocks.

Results

By using TMA kits made from cannula piercing needles (16- and 18-gauge), it was possible to construct TMAs with 1 mm×140 cores, 0.6 mm×320 cores, 2 mm×70 cores, 3 mm×35 cores, and 5 mm×12 cores. The capacity of the recipient blocks could be dramatically increased by drilling holes.

Conclusions

Construction of TMAs using self-made TMA kits is an inexpensive alternative to construction of TMAs using commercial devices.

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Optimization of Tissue Microarrays from Banked Human Formalin-Fixed Paraffin Embedded Tissues in the Cancer Research Setting
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Biopreservation and Biobanking.2019; 17(5): 452. CrossRef
Peripheral nerve sheath tumor invading the nasal cavities of a 6-year-old female Pointer dog
Alessandra Sfacteria, Laura Perillo, Francesco Macrì, Giovanni Lanteri, Claudia Rifici, Giuseppe Mazzullo
Veterinary Quarterly.2015; 35(3): 170. CrossRef
High Quality Tissue Miniarray Technique Using a Conventional TV/Radio Telescopic Antenna
Mohamed A. Elkablawy, Abdulkader M. Albasri
Asian Pacific Journal of Cancer Prevention.2015; 16(3): 1129. CrossRef
Overview on Techniques to Construct Tissue Arrays with Special Emphasis on Tissue Microarrays
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Microarrays.2014; 3(2): 103. CrossRef
Tissue Microarray
Kathleen Barrette, Joost J. van den Oord, Marjan Garmyn
Journal of Investigative Dermatology.2014; 134(9): 1. CrossRef
Altered Expression of PTEN and Its Major Regulator MicroRNA-21 in Pulmonary Neuroendocrine Tumors
Hyoun Wook Lee, Seung Yeon Ha, Mee Sook Roh
Korean Journal of Pathology.2014; 48(1): 17. CrossRef
Optimizing tissue microarray construction procedure to improve quality of sections
Hua Chang, Diane Peluso, Sadiq Hussain, Michail Shipitsin, Peter Blume-Jensen
Journal of Histotechnology.2014; 37(3): 95. CrossRef
In-house Manual Construction of High-Density and High-Quality Tissue Microarrays by Using Homemade Recipient Agarose-Paraffin Blocks
Kyu Ho Kim, Suk Jin Choi, Yeon Il Choi, Lucia Kim, In Suh Park, Jee Young Han, Joon Mee Kim, Young Chae Chu
Korean Journal of Pathology.2013; 47(3): 238. CrossRef

Case Reports

Granular Cell Astrocytoma: Report of a Case: Kyu Ho Kim, Ju Young Song, Chang Hwan Choi, Lucia Kim, Suk Jin Choi, Jee Young Han, Joon Mee Kim, Young Chae Chu, In Suh Park; Korean J Pathol. 2012;46(4):370-372. Published online August 23, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.4.370

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Abstract PDF

We report here a rare case of granular cell astrocytoma. A 75-year-old man was admitted to Inha University Hospital with a three-month history of language deterioration. In a magnetic resonance imaging, a 6.5 cm-sized heterogeneous enhancing mass was seen in both the frontal lobes and the anterior genu of the corpus callosum. A stereotactic biopsy was performed. The tumor was composed of large and small round cells with abundant intracytoplasmic granules. The nuclei were bland, round to oval, and often eccentrically located. The cytoplasm of the tumor cells was positive for glial fibrillary acidic protein and S-100 protein.

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Samuel López‐Muñoz, Borja Sánchez‐Cordon, Mario Taravilla‐Loma, Isabel Esteban‐Rodríguez
Cytopathology.2024;[Epub] CrossRef
Granular cell tumor of the brain: case report and review of literature
Shyam Duvuru, Vivek Sanker, Deepak Pandit, Sheezah Khan, Sara Alebrahim, Tirth Dave
Journal of Surgical Case Reports.2023;[Epub] CrossRef
Granular cell astrocytoma: Case report
Rohan Gupta, Supriya Gupta, Nathaniel Shapiro, Scott Rahimi, Suash Sharma
Human Pathology: Case Reports.2018; 14: 4. CrossRef
Unusual presentation of a granular cell astrocytoma
Alan A George, Gregory N Fuller, Lauren A Langford, Clayton D Simon, Amy A Zingalis, Derek A Mathis
Histopathology.2013; 63(6): 883. CrossRef

Adenocarcinoma with Intraductal Papillary Mucinous Neoplasm Arising in Jejunal Heterotopic Pancreas: Ju Young Song, Jee Young Han, Sun Keun Choi, Lucia Kim, Suk Jin Choi, In Suh Park, Young Chae Chu, Kyu Ho Kim, Joon Mee Kim; Korean J Pathol. 2012;46(1):96-100. Published online February 23, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.1.96

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Abstract PDF

A 74-year-old man suffered from jejunal perforation and adhesion to sigmoid colon due to adenocarcinoma associated with intraductal papillary mucinous neoplasm (IPMN) arising in a jejunal heterotopic pancreas. The jejunal lesion showed direct extension to the sigmoid colon, which was mistaken as sigmoid colon cancer by surgeons. Malignant transformation is a rare complication of a heterotopic pancreas. About half of malignancies in reported cases were ductal adenocarcinoma arising in the stomach, and the jejunal location is extremely rare. Furthermore, IPMN is also uncommon finding in a heterotopic pancreas.

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Intraductal Papillary Mucinous Neoplasm Arising from Heterotopic Pancreas in Stomach: A Case Report and Review of Literature
Yu Pang, Yuyu Liu, Qinqin Liu, Gang Hou
International Journal of Surgical Pathology.2023; 31(5): 708. CrossRef
Clinicopathological features of intraductal papillary mucinous neoplasm derived from ectopic pancreas: A systematic review
Jiro Kimura, Takehiro Okabayashi, Kenta Sui, Takahiro Murokawa, Motoyasu Tabuchi, Masaki Aida, Jun Iwata, Yasuhiro Hata
Surgery Open Science.2022; 8: 62. CrossRef
Clinicopathological Features of Intraductal Papillary Mucinous Neoplasm Derived from Ectopic Pancreas: A Systematic Review
Jiro Kimura, Takehiro Okabayashi, Kenta Sui, Takahiro Murokawa, Motoyasu Tabuchi, Masaki Aida, Jun Iwata, Yasuhiro Hata
SSRN Electronic Journal .2022;[Epub] CrossRef
A case of ectopic pancreas of the stomach accompanied by intraductal papillary mucinous neoplasm with GNAS mutation
Naoko Nambu, Takashi Yamasaki, Nami Nakagomi, Tsutomu Kumamoto, Tatsuro Nakamura, Akio Tamura, Toshihiko Tomita, Hiroto Miwa, Hisashi Shinohara, Seiichi Hirota
World Journal of Surgical Oncology.2021;[Epub] CrossRef
Intraductal Papillary Mucinous Neoplasm Arising in a Heterotopic Pancreas Treated by Percutaneous Endoscopic Intragastric Surgery
Shoko Moue, Yoshimasa Akashi, Koichi Ogawa, Katsuji Hisakura, Tsuyoshi Enomoto, Yusuke Ohara, Yohei Owada, Shingo Sakashita, Tatsuya Oda
The Japanese Journal of Gastroenterological Surgery.2020; 53(4): 371. CrossRef
Adenocarcinoma with intraductal papillary mucinous neoplasm arising in a duodenal heterotopic pancreas: a case report
Etsuko Hisanaga, Takaaki Sano, Norio Kubo, Norihiro Ishii, Ken Shirabe, Hitoshi Takagi, Junko Hirato, Hayato Ikota
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Irina M. Cazacu, Adriana Alexandra Luzuriaga Chavez, Graciela M. Nogueras Gonzalez, Adrian Saftoiu, Manoop S. Bhutani
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Fine Needle Aspiration Cytologic Findings of Angiosarcoma: Report of Two Cases.: Jin Xian Ji, Young Chae Chu, Lucia Kim, Suk Jin Choi, In Suh Park, Jee Young Han, Joon Mee Kim, Kyu Ho Kim, Ju Young Song; Korean J Pathol. 2011;45(2):217-222.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.2.217

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Abstract PDF

Angiosarcoma is a rare malignant vascular neoplasm which can arise in any part of the body. Specific recognition of this neoplasm in cytological specimens is difficult in the absence of an ancillary method. Herein, we present the cytologic findings of two cases of angiosarcomas diagnosed on fine needle aspiration cytology. One case is a recurred angiosarcoma in the left chest wall and the other case is a lymphedema-associated angiosarcoma in the left lower leg. The cytologic findings of both cases are similar. Cytologic features that identified this neoplasm as an angiosarcoma included arborizing microtissue fragments, irregular anastomosing vascular spaces lined by atypical cells, microacini, intracytoplasmic lumen, and intracellular red blood cells, marked cell discohesiveness, spindle to ovoid, irregular, hyperchromatic nuclei, and elongated cytoplasmic processes with indistinct borders. This report emphasizes that when aspiration smears show vasoformative features in a bloody background, angiosarcoma should be included in the differential diagnosis.

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Four newly reported ophichthid leptocephali species revealed by mitochondrial 12S rDNA, with implications of their occurrence in Korea
Hwan Sung Ji, Hae Won Lee, Byung Kyu Hong, Jin Koo Kim
Animal Cells and Systems.2012; 16(5): 415. CrossRef

Original Articles

Cytologic Features of Prostatic Adenocarcinoma in Urine: Comparison with Urothelial Carcinoma.: Lucia Kim, Joo Young Song, Suk Jin Choi, In Suh Park, Jee Young Han, Joon Mee Kim, Young Chae Chu; Korean J Pathol. 2011;45(1):79-86.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.1.79

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Abstract PDF

BACKGROUND
Prostate adenocarcinoma (PACa) cells are rarely identified in urine cytology specimens and might be easily overlooked or misdiagnosed as urothelial neoplasm when clinically unsuspected.
METHODS
We reviewed 19 urine cytology specimens obtained from 13 patients with PACa and evaluated the characteristic features discriminating PACa from urothelial carcinoma (UCa). For comparison, 27 cases of high-grade UCa (HGUCa) and 10 cases of urothelial carcinoma in situ (UCis) were also evaluated.
RESULTS
The urine cytologic evaluation of PACa revealed clustered cells forming 3-dimensional syncytial fragments with occasional microacinar grouping in a clean background. Most tumor cells were small and uniform with a high nuclear-to-cytoplasmic ratio and indistinct cell borders. The nuclei were round-to-oval and the cytoplasm was scanty and thin. One or more centrally-located prominent nucleoli were characteristically noted in one half of the cases. The nucleoli had a well-defined, large, round and eosinophilic appearance. In four high-grade cases, large tumor cells were encountered and had relatively monotonous cells with smooth-outlined cell clusters, well-defined and thin cytoplasm, and round nuclei with characteristic prominent nucleoli.
CONCLUSIONS
Combining the information of prostate cancer and the recognition of cytomorphologic features of PACa will help differentiate PACa from HGUCa and UCis.

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The diagnostic challenge of suspicious or positive malignant urine cytology findings when cystoscopy findings are normal: an outpatient blue-light flexible cystoscopy may solve the problem
Marie Andersson, Marthe Berger, Karsten Zieger, Per-Uno Malmström, Mats Bläckberg
Scandinavian Journal of Urology.2021; 55(4): 263. CrossRef
Sensitive Time-Gated Immunoluminescence Detection of Prostate Cancer Cells Using a TEGylated Europium Ligand
Nima Sayyadi, Irene Justiniano, Russell E. Connally, Run Zhang, Bingyang Shi, Liisa Kautto, Arun V. Everest-Dass, Jingli Yuan, Bradley J. Walsh, Dayong Jin, Robert D. Willows, James A. Piper, Nicolle H. Packer
Analytical Chemistry.2016; 88(19): 9564. CrossRef

Practical Standardization in Renal Biopsy Reporting.: So Young Jin, Hyeon Joo Jeong, Sun Hee Sung, Beom Jin Lim, Jee Young Han, Soon Won Hong, Hyun Ee Yim, Yeong Jin Choi, Yong Mee Cho, Myoung Jae Kang, Kyung Chul Moon, Hee Jeong Cha, Seung Yeon Ha, Mi Seon Kang, Mee Young So, Kwang Sun Suh, Jong Eun Joo, Yong Jin Kim, Nam Hee Won, Moon Hyang Park; Korean J Pathol. 2010;44(6):613-622.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.6.613

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Abstract PDF

BACKGROUND
To standardize renal biopsy reporting and diagnosis, The Renal Pathology Study Group of the Korean Society of Pathologists (RPSKSP) has developed a renal pathology reporting format for the native and allograft kidney.
METHODS
A consensus checklist of a provisional renal biopsy format was sent to all members of the RPSKSP. Feed back opinions regarding the practical application of the checklist to the diagnostic work were received.
RESULTS
Kidney biopsies require three essential examinations: by light microscopy, immunofluorescence (IF), and electron microscopy (EM). A final report of a renal biopsy should include information on specimen adequacy and a description of the morphologic change using a systematic semiquantitative method for each of the compartments, with optional separate IF and EM reports.
CONCLUSIONS
A standard renal biopsy report format is important in establishing clinicopathologic correlations, making reliable prognostic considerations, comparing the findings in sequential biopsies and evaluating the effects of therapy.

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Additional antihypertensive effect of magnesium supplementation with an angiotensin II receptor blocker in hypomagnesemic rats
Kyubok Jin, Tae Hee Kim, Yeong Hoon Kim, Yang Wook Kim
The Korean Journal of Internal Medicine.2013; 28(2): 197. CrossRef
Clinicopathologic Features of IgA-Dominant Postinfectious Glomerulonephritis
Tai Yeon Koo, Gheun-Ho Kim, Hyang Park
Korean Journal of Pathology.2012; 46(2): 105. CrossRef

Case Reports

Aspiration Cytology of Cervical Thymoma: A Case Report.: Xian Ji Jin, Ju Young Song, Suk Jin Choi, Lucia Kim, In Suh Park, Jee Young Han, Joon Mee Kim, Young Chae Chu; Korean J Pathol. 2010;44(4):444-447.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.4.444

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Abstract PDF

An ectopic cervical thymoma is an uncommon tumor of the neck displaying the same histologic features as a mediastinal thymoma. Because of its unusual location, this mass is often confused as originating from the thyroid. In this report we describe a case of cervical type AB thymoma. Aspiration cytologic smears were highly cellular and revealed irregular tissue fragments, cohesive sheets, and clusters of crowded epithelial cells intermingled with many small lymphocytes. The epithelial cells had oval and spindle shaped bland-looking nuclei and scant cytoplasm with indistinct cell borders. Mitosis, nuclear atypia, and necrosis were not observed. The cells were focally arranged in a nesting pattern. Many small lymphocytes, a few activated lymphocytes, and lymphoid tangles were seen in the background. A cytologic misdiagnosis of "possible carcinoma" was rendered. Therefore, ectopic thymoma should also be considered in fine needle aspiration cytology of a neck mass when the smear shows epithelial and lymphoid components.

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Aspiration cytology of an ectopic cervical thymoma misinterpreted as a lymphoproliferative lesion of the thyroid: A case report
YI-YING LEE, WEN-CHING WANG, CHIEN-FENG LI
Oncology Letters.2015; 10(3): 1255. CrossRef

Cytology of Follicular Dendritic Cell Sarcoma on Intraoperative Touch Imprint Smears: A Case Report.: Ju Young Song, Xian Ji Jin, Jee Young Han, Lucia Kim, In Suh Park, Joon Mee Kim, Young Chae Chu, Suk Jin Choi; Korean J Pathol. 2009;43(6):589-593.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.6.589

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Abstract PDF

Follicular dendritic cell (FDC) sarcoma is a neoplastic proliferation of FDCs. Because its cytologic findings can vary widely, both the cytomorphology and histopathology of FDC sarcoma can impose a significant diagnostic dilemma. We present cytologic features of FDC sarcoma assessed by intraoperative touch imprint. Intra-abdominal lymphadenopathies were noted in 54-year-old male with hepatitis B-virus associated liver cirrhosis. In contrast to cytologic features of classical FDC sarcoma, the tumor cells featured a large epithelioid or Reed-Sternberg cell-like shape scattered in a background with abundant inflammatory cells, which led to a mistaken diagnosis of malignant lymphoma. However, in accordance with cytologic features previously described in the literature, the tumor cells were characterized by a fragile cytoplasm with cytoplasmic processes in dendritic or reticulated patterns reminiscent of the ultrastructural features of FDC. Cytoplasmic features rendering nuclei with a tendency to form clusters or syncytial aggregates associated with reactive lymphocytes appear to be the most valuable finding in diagnosis of FDC sarcoma.

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Cytomorphology of follicular dendritic cell sarcoma: a report of 7 cases with an emphasis on the diagnostic challenges
Cody Weimholt, Jalal B. Jalaly, Cedric Bailey
Journal of the American Society of Cytopathology.2023; 12(3): 229. CrossRef
A Cytological Review of Follicular Dendritic Cell-Derived Tumors with Emphasis on Follicular Dendritic Cell Sarcoma and Unicentric Castleman Disease
José A. Jiménez-Heffernan, Cristina Díaz del Arco, Magdalena Adrados
Diagnostics.2022; 12(2): 406. CrossRef
Cytological diagnosis of follicular dendritic cell sarcoma: A case report and review of literature
A. Dutta, P. Arun, P. Roy, I. Arun
Cytopathology.2018; 29(5): 461. CrossRef

Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology in the Diagnosis of a Gastrointestinal Stromal Tumor of the Stomach: A Case Report.: Lucia Kim, Hyung Gil Kim, Young Chae Chu, In Suh Park, Suk Jin Choi, Jee Young Han, Sun Hee Kim, Don Haeng Lee, Joon Mee Kim; Korean J Cytopathol. 2008;19(2):178-182.; DOI: https://doi.org/10.3338/kjc.2008.19.2.178

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Abstract PDF: We report here a case of a gastrointestinal stromal tumor (GIST) in the stomach that was diagnosed by endoscopic ultrasound-guided fine needle aspiration cytology (EUS-FNA). A 67 year old male patient underwent regular check-ups for five years due to the presence of a submucosal tumor that was found in the fundus of the stomach incidentally. EUS-FNA was performed to evaluate the tumor, which had increased in size from 1cm to 2.8cm. A cytologic smear revealed cohesive sheets or clusters of spindle cells with elongated nuclei. Immunohistochemical staining revealed a strong positive reaction for c-kit and CD34, without any reaction for smooth muscle actin and Ki-67. Therefore, a diagnosis of GIST was made.

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